Diffuse Endobronchial Wall Spread of Metastatic Breast Cancer

Abstract

We present here a case of diffuse tracheobronchial wall spread of metastatic breast cancer who was successfully treated with trastuzumab plus vinorelbine chemotherapy. The patient had a left radical mastectomy for breast cancer in March 2000 and developed persistent cough and dyspnea in November 2006. Pulmonary function test demonstrated an obstructive pattern. Chest computed tomography showed a wall thickening of trachea and right side bronchus, but radiographic findings including ¹⁸F-fluorodeoxyglucose positron emission tomography failed to detect the locations of disease in the lung. The findings on bronchofiberscopy showed edematous tracheobronchial mucosa, but also failed to visually detect direct masses. Transbronchial biopsy specimens revealed involvement of metastatic breast cancer. The patient was treated with trastuzumab plus vinorelbine chemotherapy and the wall thickening of bronchial tree and clinical symptoms were improved. Although endobronchial metastasis in metastatic breast cancer is not uncommon, diffuse spread without forming intraluminal mass is extremely rare. The pattern of endobronchial metastasis should be considered in patients with malignancies even when radiographic abnormalities are undetectable.

Case report: Hilar metastasis of breast cancer: A single-center retrospective case-control study

“…Luminal A and luminal B were more common, but the difference was not statistically significant. This is consistent with the results of the reviewed literature ( 13 , 21 , 22 , 23 ). Further studies with larger sample sizes are warranted.…”

Endobronchial metastasis in a dog with sarcoma

“…9 In human beings, EBM has been reported in association with carcinomas of the breast, urinary bladder, prostate, and gastrointestinal tract (specifically colon) and is more rarely documented with sarcomas. [1][2][3][4]6,7,[13][14][15] Expectoration of airway casts containing neoplastic cells from EBM lesions may precede the diagnosis of the primary tumor or occur several years after treatment of a primary tumor. 3,8,9,11,12 Findings of computed tomography imaging include atelectasis and obstruction or narrowing of airways adjacent to a pulmonary mass, but do not always demonstrate the intramural nature of the lesions; the latter is often identified by bronchoscopy or histology following surgical resection of the tumor.…”