Endotracheal and endobronchial metastases from nonpulmonary malignancies are rare. Since July, 1974, eight patients with such metastases have been seen by the Thoracic Surgical Service at Stanford University Medical Center. Six patients had endobronchial metastases; two from the breast, two from the colon, one from the kidney, and one from the thyroid. Endotracheal metastases from carcinoma of the breast occurred in two patients. Prior treatment of a nonpulmonary neoplasm was known in all patients, and in six of the eight patients metastases to other sites had been previously recognized and treated. The median interval from diagnosis of the primary neoplasm to appearance of the endobronchial or endotracheal metastasis was 5 years. Median survival following diagnosis of such a metastasis was 19 months. Presenting symptoms in patients with endobronchial metastases included cough, hemoptysis, dyspnea, and wheezing. Segmental atelectasis was the major radiographic finding in five of the six patients with endobronchial lesions. Stridor and profound respiratory distress were distinguishing features of the two patients with endotracheal metastases, both of whom required emergency bronchoscopy for palliation as well as diagnosis. Histologic diagnosis of endobronchial and endotracheal metastases is essential in differentiating them from primary tumors of the tracheobronchial tree so that specific treatment may be instituted. The relatively favorable biological behavior of these tumors leads one to be optimistic about the results of treatment, although endotracheal and endobronchial metastases are generally manifestations of far-advanced disease.
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine