Intrabronchial metastases from renal carcinoma with recurrent tumour expectoration.

Abstract

Three patients are described who presented to their doctors with a history of coughing up pieces of tissue. These took the form of large bronchial casts and consisted of intrabronchial deposits of clear cell carcinoma. In one patient the pulmonary symptoms preceded the finding of a primary renal carcinoma by four years. The other two patients had undergone nephrectomy for renal carcinoma 13 and four years previously. Expectoration of intrabronchial tumour should alert the physician to the possibility of metastasis from clear cell carcinoma of the kidney.In thoracic medical practice it is rare for a patient to present his doctor with the material from which a histological diagnosis can be made without the need to submit to biopsy. We describe three such patients, all of whom expectorated tumour tissue and all of whom had intrabronchial metastasis from renal carcinoma.

Successful Management of Plastic Bronchitis in a Child Post Fontan: Case Report and Literature Review

“…Cardiac patients described by them include eight Fontan patients, three Blalock-Taussig shunt patients, and one Glenn shunt patient. Bronchial casts are noted in other disease states, such as sickle cell disease [12][13][14], metastatic lung tumors [4,15,16], viral infections [17,18], smoke inhalation [19][20][21], bronchopulmonary aspergillosis [22][23][24][25][26][27], thalassemia alpha [28], sulfur mustard inhalation [29], solvent aspiration [30], and the use of pegylated interferon [31].…”

Renal Cell Carcinoma Presenting as Endobronchial Tumor: A Case Report and Review of Literature

“…Endobronchial metastases in RCC have been reported to antedate the diagnosis by as much as four years or occur as late as 13 years after the detection of the primary tumor. 18 Our patient further illustrates the diversity of the behavior of RCC with a long interval (>1 year) between development of symptoms and detection of the primary tumor. The patient survived three years following the development of initial symptoms due to endobronchial metastasis.…”

Spontaneous expectoration of pulmonary metastases in a child with osteogenic sarcoma

“…At completion of standard chemother- Expectoration of tumor tissue is a very rare event with only 30 reported cases in the literature, 3 predominantly from metastatic cancers and only a few primary lung cancers. Most common metastatic cancers presenting as expectoration were renal cell carcinoma, [4][5][6][7] colon cancer, 8,9 and fibrosarcomas, 10,11 while common lung primary cancers presenting with expectoration include squamous cell carcinoma, small cell lung cancer, bronchogenic carcinoids, and primary sarcoma of lungs. [12][13][14][15][16] Expectoration of the primary lung cancer occurs because of exfoliation of free tumor fragments in the airway.…”

“…But endobronchial metastases expectorate by releasing tissue into the airway after treatment-related ulceration and necrosis. 5 Although endobronchial metastases are rare, they can cause airway obstruction and should be considered in the setting of acute worsening of the respiratory status. Local control with endoscopic surgery, radiation therapy, and chemotherapy can relieve the airway obstruction and improve symptoms, and should be considered.…”

“…Expectoration of the primary lung cancer occurs because of exfoliation of free tumor fragments in the airway. But endobronchial metastases expectorate by releasing tissue into the airway after treatment‐related ulceration and necrosis …”