Endotracheal/endobronchial metastases : clinicopathologic study with special reference to developmental modes

Area of Science:

• Pulmonology
• Oncology
• Pathology

Background:

• Endotracheal/endobronchial metastases (EEMs) from nonpulmonary neoplasms are rare and their developmental modes are not fully understood.
• Defining and characterizing EEMs is crucial for understanding their rare presentation and clinical impact.

Purpose of the Study:

• To define endotracheal/endobronchial metastases (EEMs) from nonpulmonary neoplasms.
• To elucidate the developmental modes of EEMs based on clinical and pathological features.
• To analyze the clinical characteristics and survival outcomes of patients with EEMs.

Main Methods:

• Defined EEMs as nonpulmonary neoplasms metastatic to the central bronchus within bronchoscopic view.
• Reviewed clinical and pathological features of 16 cases, focusing on five criteria for developmental modes.
• Classified developmental modes into Type I (direct metastasis), Type II (parenchymal invasion), Type III (lymph node invasion), and Type IV (peripheral extension).

Main Results:

• Four developmental modes were proposed: Type I (5 patients), Type II (1 patient), Type III (4 patients), and Type IV (9 patients).
• Colorectal cancer was the most common primary tumor (6 patients).
• The mean recurrence interval was 65.3 months, with a median survival of 9 months and mean survival of 15.5 months. One patient achieved 5-year survival post-resection.

Conclusions:

• EEMs have a long recurrence interval but poor short-term survival.
• Type IV EEMs, involving peripheral lesions extending proximally, were the most frequent.
• Individualized treatment is essential, as some patients may experience long-term survival.