High-Dose-Rate Endobronchial Brachytherapy in Endobronchial Metastatic Malignant Chondroid Syringoma

Solomonov, Anna; Rosenblatt, E.; Ben‐Izhak, Ofer; Goralnik, L.; Yigla, Mordechai

doi:10.1159/000050536

Cited by 11 publications

(19 citation statements)

References 15 publications

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“…Intraluminal radiotherapy is one of the treatment choices for the palliation of symptoms [21][22][23]. However, its effect on survival time has not yet been fully elucidated.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial Metastases from Extrathoracic Malignancies

Akoglu

Uçan

Çelik

et al. 2005

Clin Exp Metastasis

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Endobronchial metastases (EBM) from extrapulmonary malignant tumors are rare. The most common extrathoracic malignancies associated with EBM are breast, renal and colorectal carcinomas. In this study, we aimed to evaluate the clinical, radiographic and bronchoscopic aspects of patients with EBM who were diagnosed between 1992 and 2002. Data about patients' clinical conditions, symptoms, radiographic and endoscopic findings, and histopathological examination results were investigated. EBM was defined as bronchoscopically visible lesions histopathologically identical to the primary tumor in patients with extrapulmonary malignancies. We found 15 cases with EBM. Primary tumors included breast (3), colorectal (3), and renal (2) carcinomas; Malignant Melanoma (2); synovial sarcoma (1), ampulla of Vater adenocarcinoma (1), pheochromocytoma (1), hypernephroma (1), and Hodgkin's Disease (1). The most common symptoms were dyspnea (80%), cough (66.6%) and hemoptysis (33.3%). Multiple (40%) or single (13.3%) pulmonary nodules, mediastinal or hilar lymphadenopathy (40%), and effusion (40%) were the most common radiographic findings. The mean interval from initial diagnosis to diagnosis of EBM was 32.8 months (range, 0-96 months) and median survival time was 18 months (range, 4-84). As a conclusion, various extrapulmonary tumors can metastasize to the bronchus. Symptoms and radiographic findings are similar with those in primary lung cancer. Therefore, EBM should be discriminated from primary lung cancer histopathologically. Although mean survival time is usually short, long-term survivors were reported. Consequently, treatment must be planned according to the histology of the primary tumor, evidence of metastasis to other sites and medical status of the patient.

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“…Intraluminal radiotherapy is one of the treatment choices for the palliation of symptoms [21][22][23]. However, its effect on survival time has not yet been fully elucidated.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial Metastases from Extrathoracic Malignancies

Akoglu

Uçan

Çelik

et al. 2005

Clin Exp Metastasis

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“…21 Metastasizing malignant chondroid syringoma was first reported by Rosborough in 1963. 12 Distant metastases occur after multiple local recurrences of the primary tumor and have been observed in approximately 40% of cases, usually involving the lymph nodes, 21 lungs, 8,16 or both. Bone and widespread metastases are less common.…”

Section: Discussionmentioning

confidence: 99%

“…18 Complementing surgical treatment with radiotherapy for this entity is still controversial. 2,6,16 Although local radiotherapy is often unsuccessful, skeletal metastases have shown a response to radiotherapy. If we take into account all malignancies, Level I evidence suggests that surgery followed by radiotherapy remains the treatment of choice for selected patients presenting with spinal cord compression caused by a metastatic lesion.…”

Section: Discussionmentioning

confidence: 99%

“…3,15 Although malignant chondroid syringoma can progress very slowly, recurrence and metastasis are frequent, usually involving the lymph nodes, lungs, or both. 1,8,16,21 Bone and widespread metastases are less common. 7,17,22 We identified only one other report describing spinal cord compression secondary to the metastasis of a malignant chondroid syringoma, but the definitive diagnosis was made by autopsy.…”

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Spinal cord compression secondary to metastasis of malignant chondroid syringoma: case report

Menéndez¹,

Erice²,

Bas³

et al. 2015

SPI

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The authors describe a case of spinal cord compression due to an epidural metastasis of malignant chondroid syringoma. Chondroid syringoma is a rare mixed tumor of the skin composed of both epithelial and mesenchymal elements. Although most are benign, malignant forms have been reported. Malignant chondroid syringoma may progress very slowly and the metastatic spread occurs late, appearing years after the original diagnosis. There is only one other report of spinal cord compression secondary to metastasis of malignant chondroid syringoma, which was finally diagnosed by microscopic examination of an autopsy specimen. This 63-year-old woman presented with a 4-week history of progressive paraparesis. Admission MRI of the thoracic spine showed an extradural mass arising from the posterior elements and left pedicle of T-9, which caused posterior compression of the spinal cord. Surgical decompression resulted in resolution of the neurological impairments. The histological results were consistent with metastasis of malignant chondroid syringoma. The patient underwent adjuvant radiotherapy and a favorable outcome was noted at the 2-year follow-up visit. This represents the first reported case of spinal cord compression from a metastasis of a malignant chondroid syringoma histologically confirmed in vivo. The authors' experience in this case suggests that resection followed by radiotherapy might be an acceptable means for achieving short-term, progression-free survival.

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“…Intraluminal brachytherapy, cryotherapy and Nd-Yag laser are efficient treatment options for the palliation of symptoms [17,18,19]. The local treatment of this metastatic lesion should be individualized and aimed at improving symptoms.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial Metastases from Colorectal Adenocarcinomas: Clinical and Endoscopic Characteristics and Patient Prognosis

Díaz¹,

Fouchardière²,

Desseigne³

et al. 2007

Oncology

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Background: Endobronchial metastases (EBM) secondary to extrapulmonary solid malignant tumours are rare but may occur. The most common extrathoracic malignancies associated with EBM are breast, renal and colorectal carcinomas. This study aimed to evaluate the clinical and bronchoscopic aspects of EBM from colorectal carcinomas and the prognosis of the patients. Methods: EBM were diagnosed in 7 patients with colorectal carcinomas between 2004 and 2005. All patients underwent colorectal resection at the time of primary tumour diagnosis. Bronchial involvement was proved by bronchoscopy, and the metastatic nature of the lesions was confirmed histopathologically in all patients. EBM patients were compared with a control group of 7 patients with pulmonary metastases from colorectal cancer. Results: Median age at time of colorectal carcinoma was 55 years in EBM patients and 57 years in controls. Distressing airway symptoms caused by EBM were relieved by use of newer intrabronchial therapies: radiotherapy, brachytherapy and cryotherapy. One patient underwent metastasis resection. The median survival after diagnosis of EBM was 18.9 months. All patients had pulmonary metastases. The median survival after diagnosis of pulmonary metastasis from colorectal carcinoma was 55.7 months in EBM patients and 12.7 months in controls (p < 0.005). Discussion: EBM are generally underdiagnosed in patients with colorectal carcinoma. Bronchoscopy is not part of the standard evaluation of these patients. Physicians must be more attentive to pulmonary symptoms, even when patients’ pulmonary metastases are known. Various management options are available for localized endobronchial tumours. Conclusion: On average, EBM are diagnosed about 5 years after the diagnosis of the primary tumour, which is a relatively long lead time. Although this metastatic location usually implies a very negative prognosis regarding life expectancy, it did not seem to significantly reduce survival in our patients. Local treatments allow substantial improvement of pulmonary symptoms.

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High-Dose-Rate Endobronchial Brachytherapy in Endobronchial Metastatic Malignant Chondroid Syringoma

Cited by 11 publications

References 15 publications

Endobronchial Metastases from Extrathoracic Malignancies

Endobronchial Metastases from Extrathoracic Malignancies

Spinal cord compression secondary to metastasis of malignant chondroid syringoma: case report

Endobronchial Metastases from Colorectal Adenocarcinomas: Clinical and Endoscopic Characteristics and Patient Prognosis

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