Endotracheal and/or Endobronchial Metastases Occuring after Resection of Primary Lung Cancer

Abstract

Eight lesions in 5 cases with endotracheal and/or endobronchial metastases occured after resection of primary lung cancer. Evaluation of clinical features and bronchofiberscopic findings were performed and the effect of intraluminal irradiation therapy was analyzed. All patients were male. The histologic type was squamous cell carcinoma in 4 out of 5 cases and adenocarcinoma in the other case. The interval between pulmonary resection and the detection of the metastatic lesions in these cases were all within 3 years, and the average was 16.4 months. The first symptom was bloody sputum in all cases. Bronchofiberscopy showed semipedunculated elevated tumors in squamous cell carcinomas, and a protruding lesion resembling a submucosal tumor in the adenocarcinoma case. One case was treated by external irradiation alone. The other 4 cases were treated by a combination of external and intraluminal irradiation. New applicators developed by us with ^<192>Iridium thin wires as radiation sources were used for intraluminal irradiation. No particular complications were noticed during treatment. All lesions endoscopically disappeared after treatment and cytologic examination was negative. Although 2 cases died due to distant metastases, airway lesions were not recognized until death. The other 3 cases are still alive without recurrence. Intraluminal irradiation with the new applicator is useful for local treatment of lesions to which cannot be given sufficent external irradiation.