Tracheobronchial obstruction from metastatic distant malignancies

Tracheal or endobronchial metastases from distant primary malignancies are rare. Hemoptysis, dyspnea and cough are common nonspecific presenting symptoms. Renal, breast, thyroid and colon cancers are the most common malignancies associated with tracheobronchial metastases. Since 1979, five patients with tracheobronchial metastases from distant sites have been treated by the otolaryngology service at the Boston University Medical Center. Patients with advanced tumors previously treated by conventional modalities were referred for palliation of airway obstruction. Satisfactory palliation without significant morbidity was achieved in four out of five patients utilizing a CO2 surgical laser through a rigid bronchoscope system. Four patients died from advanced cancer, 1 to 18 months after laser surgery. Although tracheobronchial metastasis from extrathoracic malignancy is associated with a poor prognosis, palliation of airway obstruction can be achieved in most patients with endobronchial or tracheal tumor.