Late Endobronchial Pulmonary Metastasis in a Patient with Breast Cancer

Abstract

The lung is a common location for malignant metastases. However, endobronchial metastases from nonpulmonary neoplasms are rare. Metastatic breast cancer usually occurs in 2-3 years of the disease course. A 65-year-old woman visited our hospital for the evaluation of dry cough. The patient had a history of breast cancer, which was treated with modified radical mastectomy and axillary dissection 10 years ago; she was then treated with aromatase inhibitor for 5 years. Chest X-ray revealed right hilum enlargement. Thorax computed tomography revealed a 35-mm diameter mass that was localized in the right hilum. Fiberoptic bronchoscopy was performed, and an endobronchial lesion was observed in the right main lobe carina. Pathological evaluation revealed that the mass was a metastasis of the invasive ductal carcinoma of the breast. Weekly paklitaxel chemotherapy was initiated because of the symptomatic disease. We reported the case of a patient with breast cancer who had an endobronchial metastasis. Her disease-free interval was 10 years. This case indicates that a long-term follow-up of breast cancer is necessary, and biopsies must be performed to make a final diagnosis when any suspicious hilum enlargement is observed.

Endobronchial metastasis from extrathoracic malignancies: A clinicopathological study of 11 cases

“…The most common symptoms mentioned are cough and hemoptysis followed by dyspnea and wheezing in patients with EBM. [ 10 11 12 13 14 15 16 ] In our series, cough was the most frequent symptom followed by chest pain and dyspnea. This indicates that if there is any one of these symptoms in a patient with extrapulmonary malignancy, especially breast, colon or renal tumors, bronchoscopic examination is must to exclude EBM.…”

“…According to the literature, EBM is observed in various types of malignancies, including colorectal, breast, kidney, stomach, ovarian, thyroid, uterine, testicular, nasopharynx, prostate, adrenal carcinomas, sarcomas, histiocytoma, and plasmacytomas. [ 10 11 12 13 14 15 16 ] The most common EBM is from carcinomas of the colorectal region followed by the breast and kidney. [ 13 14 15 ] This was very well correlated with our study as carcinoma breast and colon were the most common.…”

“…[ 10 11 12 13 14 15 16 ] The most common EBM is from carcinomas of the colorectal region followed by the breast and kidney. [ 13 14 15 ] This was very well correlated with our study as carcinoma breast and colon were the most common. EBM is clinically, radiologically, and bronchoscopically indistinguishable from that of primary bronchogenic carcinoma in most cases.…”

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

“…Some studies consider metastatic lesions in the hilum as bronchopulmonary metastasis ( 16 ). The incidence of bronchopulmonary metastasis is the highest among breast, colon, and kidney cancers ( 17 , 18 ). Clinical manifestations include cough, chest tightness, and hemoptysis.…”