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Vol.40 No.6 contents | Japanese/English |
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- Case Report -
Postoperative Endotracheal Metastasis of the Peripheral Adenocarcinoma of Lung. -A Case Report with Review of the Japanese Literature-
Masataka Segawa1, Yoshinori Kusajima1, Hiroyuki Nakamura2, Masami Sugihara3 and Katsuhiko Saito41Department of Thoracic and Vascular Surgery, Toyama City Hospital, 2Department of Medicine, Toyama City Hospital, 3Department of Radiology, Toyama City Hospital, 4Department of Pathology, Toyama City Hospital
Background: Endotracheal metastasis of lung cancer is rare. Only 14 cases have been reported in Japan. Case: A 65-year-old man was admitted complaining of bloody sputum. He had a history of S1+S2a segmental excision of the right lung and mediastinal lymph node dissection on a diagnosis of the adenocarcinoma of S1a segment (pT1N0M0) about 45 months before. Bronchoscopic examination revealed a submucosal growth tumor 3 cm in diameter in the left lateral wall of the middle third of trachea, obstructing more than half of the lumen. The tumor was sessile and soft, and had a reddish smooth surface. The biopsy specimen of the tumor was suspected to be metastasis from lung cancer. The radiological findings showed the tracheal cancer to be localized in the tracheal wall and no other malignant lesions were pointed out. He was treated with excision of the tracheal tumor under tracheotomy followed by 60 Gy radiation therapy. The tracheal cancer and the lung cancer had similar histological findings. These tumors were diagnosed as poorly differentiated adenocarcinoma. Immunohistochemically, both the tumor cells of the trachea and the lung were positive for CEA. Moreover, the serum CEA level elevated before the operation and dropped to the normal range after treatment. This evidence supports the diagnosis of endotracheal metastasis of the lung cancer. Conclusion: We presented a rare case of endotracheal metastasis of lung cancer.
key words: Lung cancer, Adenocarcinoma, Peripheral, Postoperative recurrence, Tracheal metastasis
Received: March 9, 2000
Accepted: June 7, 2000
JJLC 40 (6): 633-637, 2000
