Endotracheal/endobronchial metastases; a clinicopathological study with special reference to developmental modes based on primary sites

Purpose : To evaluate the developmental modes of endotracheal/endobronchial metastases (EEM) based on each primary sites. Materials and Method : EEM were defined as documented nonpulmonary neoplasms metastatic to the subsegmental or more proximal central bronchus, in a bronchoscopically visible range. The clinical and pathological features of 20 cases were reviewed, with special emphasis on primary sites and developmental modes. The relationship with the associated bronchus was proposed as follows, type I : direct metastasis to the bronchus, type II : bronchial invasion by a parenchymal lesion, type III : bronchial invasion by mediastinal or hilar LN metastasis, and type IV : peripheral lesions extended along the proximal bronchus. Result : Primary tumors included colorectal in 7, breast in 5, uterus in 2, osteosarcoma of the bone in 2, larynx in 2, and maxillary and parotid carcinoma in one case, respectively. 5 of 7 cases with EEM from colorectal carcinoma revealed type IV, with lesions located in peripheral sites. 3 of 5 cases with EEM from breast carcinoma showed type I, remainders type III, and 4 cases had EEM in trachea. 1 case with EEM from osteocsaecoma that underwent surgical procedures is alive and well 76 months after resection of EEM. Conclusion : Treatment plans must be individualized, because in some cases, long-term survival can be expected.