Endobronchial metastases secondary to solid tumors: report of eight cases and review of the literature

Endobronchial metastases (EBM) secondaries to extrapulmonary solid malignan t tumors are rare. Breast, colon and renal adenocarcinomas are the most fre quent tumors associated with EBM. Since 1990 we have treated eight patients with EBM secondary to renal adenocarcinoma (three cases), colon adenocarci noma (two cases), gastric adenocarcinoma (one case), bladder carcinoma tone case) and basal cell carcinoma tone case). Endobronchial lesions were dete cted by bronchoscopy and their metastatic nature was confirmed histopatholo gically in all eight cases. We also conducted a review of EBM reporting stu dies published in English language. The median interval from the diagnosis of the primary turnout was 41 months. Symptoms and radiological findings we re indistinguishable from those of primary lung cancer. Five patients were treated with external radiotherapy with symptomatic improvement while two p atients had chemotherapy and one patient underwent surgical resection of th e metastasis. Systemic treatment was used in six cases with no significant effect on EBM. Median survival after EBM diagnosis was 9 months with one pa tient surviving 3.5 years and two patients still alive at 1 year. In conclu sion, EBM usually represent a late manifestation requiring differential dia gnosis from a primary lung cancer. Local treatment may result in symptomati c improvement but prognosis is generally poor averaging 1-2 years in most s eries. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.