A resected case of localized endobronchial metastasis with metastatic lung tumor from colorectal cancer

Abstract

A 66-year-old man, who had been treated surgically for “Dukes A” rectal cancer 56 months previously, was referred for evaluation of pulmonary nodule on chest rentgenogram. He had been complaining of intermittent nonproductive cough for a period of one month. Chest CT showed a solitary nodule, about 25 mm in diameter in the middle lobe. Bronchoscopy revealed a polypoid tumor, visualized at the entrance of the middle lobe bronchus, separate from a peripheral invisible tumor in the middle lobe. Biopsy specimens from both the pulmonary tumor and bronchial tumor were shown to be adenocarcinoma and were strongly suspected to be metastasis from the rectal cancer. Middle wedge lobectomy was performed. No lymph node metastasis was identified around the bronchus. The resected specimens showed no connection between the lung metastasis and the tumor at the entrance of the middle lobe bronchus, with no residual tumor existing. Although endobronchial metastasis is not still clearly defined, it is generally considered that localized endobronchial metastasis is rare, and resectable cases are also rare. Bronchofiberscopy should be performed to decide the therapeutic principle in a patient with metastatic lung tumor, even if the patient has no respiratory symptoms.