Successful treatment of refractory bronchorrhea by inhaled indomethacin intwo patients with bronchioloalveolar carcinoma

Bronchorrhea in patients with bronchioloalveolar carcinoma is not uncommon, However to our knowledge, an effective treatment for bronchorrhea in these patients has not been established. Recently, we have confirmed the efficac y of inhaled indomethacin in severe refractory bronchorrhea in comparison t o that of other medications in two patients with bronchioloalveolar carcino ma. Despite the administration of a macrolide and corticosteroid, sputum vo lume increased to 700 mL/d in case 1 and to 200 mL/d in case 2 and hypoxemi a and dyspnea deteriorated. Within a fen days after the initiation of treat ment with inhaled nebulized indomethacin (75 mg/d), sputum volume started t o decrease and was controlled to < 100 mL/d, associated with alleviation of dyspnea and hypoxemia. To our knowledge, this is the first report of succe ssfully treated refractory bronchorrhea associated with bronchioloalveolar carcinoma by inhaled indomethacin, resulting in markedly reduced sputum vol ume, improved quality of life, and prolonged survival.