A Rare Case of Metastatic Lung Cancer with a Cavitary Lesion which was Examined by Bronchofiberscopy

Abstract

A 54-year-old male underwent resection of an oral tumor (squamous cell carcinoma) in 1984, and chest X-ray showed multiple cavitary shadows in January, 1987. After transient expectoration of large amounts of bloody purulent sputum, his general condition deteriorated and he was admitted to the hospital. Chest X-ray on admission showed multiple nodules with thin-walled cavities. Bronchofiberscopy showed fistula to the tumor cavity at the bifurcation of the right upper lobe bronchus and the truncus intermedius and the inner surface of the cavity showed a milky-white ventricle-like structure. The biopsied specimen from the inner surface of the cavity revealed squamous cell carcinoma, probably metastatic. There was a small aperture on the opposite wall of the cavity, which was identified to be right B3 bronchus by bronchography. There have been some reports of observation of the inner surface of cavities of primary lung cancer, but reports on metastatic cases are few. Our case is provides information on the mechanism of the development of the cavity.