A Case of Lung Adenocarcinoma with Postoperative Endobronchial Metastasis

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  • 手術後に気管支内転移を認めた肺腺癌の1例

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Abstract

<p>Background. There are few case reports on primary lung cancer with endotracheal or endobronchial metastases. We report a case of primary lung adenocarcinoma with endobronchial metastasis. Case. The patient was a 63-year-old man with a previous spinal cord injury. He underwent surgery for primary lung cancer at 62 years of age. The lung cancers were a right upper lobe adenocarcinoma (pT1cN0M0 pStage IA3), and a right middle lobe adenocarcinoma (pTisN0M0 pStage 0). We performed video-assisted right upper and middle lobectomy with lymph node dissection. During treatment for an infected decubitus ulcer on admission, at 6 months after the operation, his respiratory condition deteriorated with desaturation and wheezing. Chest CT revealed right pleural effusion, superior mediastinal lymphadenopathy, and a space-occupying lesion at the left main bronchus. Bronchoscopy revealed a pedunculated polyp occupying the left main bronchus. Bronchoscopic tumor resection with electrocautery was performed. Subsequently, his symptoms showed a remarkable improvement. The excised left bronchial tumor was diagnosed as metastasis from the primary lung cancer (epidermal growth factor receptor mutation-positive/exon 19 deletion). Osimertinib was introduced as an additional treatment, after which chest CT revealed the disappearance of the pleural effusion, reduction of the superior mediastinal lymphadenopathy, and no local recurrence of the tumor in the left main bronchus. A chest CT scan performed 6 months after the introduction of medication showed no signs of relapse and no local recurrence was detected. Conclusion. Bronchial metastasis of lung cancer is relatively rare; thus, the present case is valuable.</p>

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