Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan.
Department of Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan.
Thorac Cancer. 2021 Jan;12(1):133-136. doi: 10.1111/1759-7714.13730. Epub 2020 Nov 14.
The occurrence of endotracheal/endobronchial metastasis (EEM) after complete resection of a primary lung cancer is rare. Here, we report the case of an 86-year-old woman in whom EEM occurred twice over a 20-year period following complete resection of a primary adenocarcinoma localized to the left main bronchus and trachea. The presence of EEM was confirmed by establishing immunohistochemical homology of the metastases with the primary tumor. To the best of our knowledge, this is the first reported case of repetitive EEM of primary lung adenocarcinoma. Lymphatic invasion in the primary lesion suggested that a possible route for EEM was the peripheral lymphatic tract, explaining the slow recurrence rate. We conclude that observation of the trachea/bronchus over a long period post operation could be important in monitoring for EEM, particularly if lymphatic invasion is confirmed in the primary tumor.
原发性肺癌完全切除术后发生气管/支气管内转移（EEM）的情况较为罕见。在此，我们报告一例 86 岁女性病例，其在原发性左主支气管和气管腺癌完全切除后 20 年内发生了两次 EEM。转移灶与原发性肿瘤的免疫组织化学同源性证实了 EEM 的存在。据我们所知，这是首例报道的原发性肺腺癌重复发生 EEM 的病例。原发性病变中的淋巴浸润提示 EEM 可能通过外周淋巴管发生，这解释了其复发率较低的原因。我们得出结论，术后长期观察气管/支气管对于监测 EEM 非常重要，特别是如果原发性肿瘤中存在淋巴浸润的话。
