Endobronchial Metastasis from an Osteosarcoma Case

Pulmonary metastases from extrathoracic malignan-cies are common and frequently seen as parenchy-mal nodules and pleural involvement. Endobronchial metastases are rare. We present a 34-year-old male who was diagnosed with right humerus osteosarcoma 10 months ago. Although the primary tumor had been controlled with surgical resection following preoperative chemotherapy and postoperative adjuvant chemotherapy, he had hemoptysis. He was admitted to another center two weeks ago with progressive dyspnea and episodes of hemoptysis within six weeks. Rigid bronchoscopy was performed for left lung atelectasis and tumor obstructing distal part of left main bronchus was removed. The pathological evaluation revealed osteosarcoma metastasis. In our clinic, we performed a thorax computerized tomography showing multiple metastases, the largest located in the apical segment of the lower left lobe. A tumoral lesion nearly obstructing the lower left lobe bronchus was seen during fiberoptic bronchoscopy. The tumor was inappropriate for endobronchial treatment and palliative external radiotherapy was planned.

Endobronþiyal Metastaz Yapan Osteosarkom Olgusu

Akciðerler, ekstratorasik malignitelerin sýk metastaz yaptýðý organlardýr. Metastazlar sýklýkla parankimal nodüller veya plevra tutulumu þeklinde olup endobronþiyal metastazlar nadirdir. Bu makalede görece olarak daha nadir görülen endobronþiyal metastaz yapan osteosarkom olgusundan bahsedilecektir. Otuz dört yaþýndaki erkek olgu, 10 ay önce sað humerustaki kitleden yapýlan biyopsiyle osteosarkom tanýsý almýþtý. Neoadjuvan kemoterapi sonrasýnda opere edilen ve adjuvan kemoterapi alan hastanýn kol bölgesindeki tümörü kontrol altýndaydý. Baþvurusundan iki hafta önce baþka bir merkeze 6 haftadýr artan nefes darlýðý ve hemoptizi yakýnmalarýyla baþvurmuþ, sol akciðerinde total atelektazi saptanmýþtý. Sol ana bronþ distalinde lümeni tam týkayan endobronþiyal lezyon rijid bronkoskop ile çýkarýlmýþ, patolojik incelemesi osteosarkom metastazý olarak deðerlendirilmiþti. Devam eden hemoptizi yakýnmasýyla kliniðimize baþvuran hastanýn toraks bilgisayarlý tomografisinde büyüðü sol alt lob superior segmentte olan, çok sayýda metastatik kitle ve nodüller saptandý. Fiberoptik bronkoskopik incelemede sol alt lob bronþu giriþini tama yakýn týkayan tümöral lezyon izlendi. Endobronþiyal tedaviye uygun bulunmayan hastaya palyatif amaçlý eksternal radyoterapi planlandý.