Background: Endotracheal/endobronchial metastases
(EEMs) from nonpulmonary neoplasms are rare. However, their definition
and developmental modes have not yet been fully elucidated.
Methods: EEMs were defined as documented nonpulmonary
neoplasms metastatic to the subsegmental or more proximal central
bronchus, in a bronchoscopically visible range. The clinical and
pathologic features of 16 cases were reviewed, with special emphasis on
the developmental modes based on five criteria: location in the
tracheobronchial tree, number of lesions, laterality of lesions, depth
of lesions, and relationship with the associated bronchus.
Results: The developmental modes were proposed on the basis
of the above five criteria as follows: type I, direct metastasis to the
bronchus; type II, bronchial invasion by a parenchymal lesion; type
III, bronchial invasion by mediastinal or hilar lymph node metastasis;
and type IV, peripheral lesions extended along the proximal bronchus.
Primary tumors included colorectal in six patients, breast in three
patients, uterus in two patients, osteosarcoma of the bone in two
patients, and maxillary, larynx, and parotid carcinoma in one patient
each, respectively. The mean recurrence interval was 65.3 months. The
developmental modes were as follows: type I, five patients; type II,
one patient; type III, four patients; and type IV, nine patients. Three
patients underwent surgical resection. One patient has remained well
for 5 years after operation. Median and mean survival times were 9
months and 15.5 months, respectively.
mean recurrence interval was long at 65.3 months, but the mean survival
time was short at 15.5 months. Type I accounted for only 5 of 16
patients. Type II was found in only one patient. It is thought that
this type is a rare form. Type IV affected nine patients. Treatment
plans must be individualized, because in some cases, long-term survival
can be expected.