Tuberc Respir Dis.  2013 Dec;75(6):250-255.

Adjuvant Treatment of Proper Endobronchial Management in Leiomyosarcoma

• Kim SJ
• Kim J
• Park JH
• Lee AR
• Lee JK
• Kim TM
• Park YS

Abstract

Endobronchial metastasis of leiomyosarcoma is rare, but it can cause life-threatening complications, such as massive hemoptysis, respiratory failure or even death. The development of new endoscopic modalities allows for effective endobronchial management. We report three patients with endobronchial metastases from advanced leiomyosarcomas which caused bronchial obstruction. The bronchoscopic examinations revealed masses obstructing the left main bronchus in all three patients. After removing the endobronchial tumor via interventional bronchoscopy, there was symptomatic and radiologic improvement. Moreover, the patients were able to undergo additional palliative chemotherapy. Therefore, endobronchial management of endobronchial tumors should be considered in the treatment of endobronchial metastasis, even in patients with advanced malignancies.

Keyword

Bronchoscopy; Palliative Care; Leiomyosarcoma; Neoplasm Metastasis

MeSH Terms

Bronchi
Bronchoscopy
Drug Therapy
Hemoptysis
Humans
Leiomyosarcoma*
Neoplasm Metastasis
Palliative Care
Respiratory Insufficiency

Figure

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  Figure 1 (A) A chest radiograph revealed haziness of the left hemithorax, suggesting atelectasis of the left lung. (B) After bronchoscopic intervention, resolution of atelectasis was shown.

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  Figure 2 Bronchoscopic examination showed a huge encapsulated mass obstructing the distal left main bronchus.

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  Figure 3 Pathologic findings of endobronchial tumors revealed spindle cell neoplasm (A and C; H&E stain, ×100). High power demonstrates spindle cells with blunt ended (cigar-shaped) nuclei and prominent cytologic atypia (B and D; H&E stain, ×400).

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  Figure 4 (A) A chest radiograph revealed haziness of the left hemithorax, suggesting atelectasis of the left lung. (B) After bronchoscopic intervention, a chest radiograph showed improvement of atelectasis.

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  Figure 5 Bronchoscopic examination revealed a mass with smooth mucosal surface obstructing the proximal left main bronchus.

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  Figure 6 A 5-cm mass with smooth mucosal surface was extracted from the left main bronchus.

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  Figure 7 (A) A chest radiograph revealed haziness of the left hemithorax, suggesting atelectasis of the left lung. (B) After bronchoscopic intervention, chest radiography demonstrated resolution of atelectasis and multiple pulmonary metastases.

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  Figure 8 (A) Bronchoscopic examination shown by a whitish mass with smooth surface obstructing the left main bronchus. (B) Recanalization of the left main bronchus via interventional bronchoscopy was performed.

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  Figure 9 A 6-cm mass with smooth mucosal surface was extracted from the left main bronchus.

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