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Lung Cancer |

Bronchoscopic Ablation of Endobronchial Metastasis From Ovarian Cancer

Christopher Yee, MD; David Hsia, MD
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Harbor-UCLA Medical Center, Torrance, CA


Chest. 2014;146(4_MeetingAbstracts):614A. doi:10.1378/chest.1990336
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Abstract

SESSION TITLE: Cancer Case Report Posters I

SESSION TYPE: Affiliate Case Report Poster

PRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PM

INTRODUCTION: Tracheobronchial metastases are uncommon presentations of metastatic malignancies; ovarian cancer is a particularly rare etiology. We present a case of ovarian tracheobronchial metastasis treated with bronchoscopic ablation.

CASE PRESENTATION: In 2004, a 59 year-old woman was diagnosed with ovarian cancer for which she underwent extensive abdominal surgical resection and chemotherapy. She had additional surgical debulking and chemotherapy for several recurrences of malignancy. In 2013, she developed cough, wheezing, and dyspnea. A 2 cm polyploid mass obstructing the bronchus intermedius was seen on chest CT and bronchoscopy. Biopsies were consistent with the original malignancy. The patient was referred to our hospital for a therapeutic intervention to palliate symptoms. Patency of the bronchus intermedius was reestablished by flexible bronchoscopy with electrocautery snare resection of the pedunculated mass and probe ablation of the base (Figure). The patient tolerated the procedure well and resumed treatment with her referring physicians.

DISCUSSION: Bronchial metastases from ovarian cancer are exceptionally rare. A series of 911 patients with resected thoracic metastases included only 58 cases with tracheobronchial metastasis.1 Tracheobronchial metastases were most commonly from cervical/uterine and breast malignancies. Only one case in this series and few others in the medical literature have been reported from ovarian cancer. Clinically significant lesions are often characterized by symptoms of cough, hemoptysis, dyspnea, and wheezing. Tracheobronchial metastases typically appear after long latency periods from the time of original diagnosis (4-12 years). Previously described cases of ovarian tracheobronchial metastases have been managed in various ways, but only one other case reported bronchoscopic removal with electrocautery snare resection.2 Fortunately, tracheobronchial metastases are associated with a more favorable prognosis compared with other thoracic metastases.

CONCLUSIONS: This case highlights a rare finding of bronchial metastasis from ovarian cancer. It is a potentially late-presenting complication that can be treated with bronchoscopy to palliate symptoms and improve quality of life.

Reference #1: 1Cicero R, Navarro F, Correa E, et al. Endobronchial metastasis: experience in two tertiary care hospitals. J Bronchology Interv Pulmonol. 2001;8:84-7.

Reference #2: 2Choi HS, Kim SY, Choi CW, et al. Use of bronchoscopic electrocautery in removing an endotracheal metastasis. Lung Cancer. 2007;58(2):286-90.

DISCLOSURE: The following authors have nothing to disclose: Christopher Yee, David Hsia

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