You Jae Hyung, Jeong Young Beom
Department of Urology, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.
Case Rep Oncol. 2023 Sep 27;16(1):1048-1053. doi: 10.1159/000533893. eCollection 2023 Jan-Dec.
The most common primary tumors associated with endobronchial metastasis (EBM) are colorectal, breast, and renal. When EBM is present, respiratory symptoms such as shortness of breath or hemoptysis accompanied by coughing usually appear. Herein, we report a case of atelectasis caused by EBM of renal cell carcinoma (RCC) in a 53-year-old man who underwent laparoscopic radical nephrectomy for RCC 5 years ago. The patient's primary RCC stage was pT1b, and the histological cell type was clear cell RCC with Fuhrman nuclear grade 3/4. At the time of EBM diagnosis, the patient was classified as "favorable" according to IMDC (International mRCC Database Consortium) risk calculator. The patient refused surgical treatment and received targeted therapy with sunitinib. A tumor mass spontaneously detached and came out through the airway during targeted therapy. Subsequently, the patient's respiratory symptoms were alleviated, and his atelectasis disappeared. This case shows that when there is atelectasis due to EBM of RCC, the obstructed bronchus may be reopened with targeted therapy without any interventional treatment.
与支气管内转移(EBM)相关的最常见原发性肿瘤是结直肠癌、乳腺癌和肾癌。当出现EBM时,通常会出现呼吸症状,如呼吸急促或咯血并伴有咳嗽。在此,我们报告一例53岁男性因肾细胞癌(RCC)的EBM导致肺不张的病例,该患者5年前因RCC接受了腹腔镜根治性肾切除术。患者原发性RCC分期为pT1b,组织学细胞类型为透明细胞RCC,Fuhrman核分级为3/4级。在EBM诊断时,根据IMDC(国际转移性RCC数据库联盟)风险计算器,该患者被归类为“有利”。患者拒绝手术治疗,接受了舒尼替尼靶向治疗。在靶向治疗期间,肿瘤块自发脱落并通过气道排出。随后,患者的呼吸症状得到缓解,肺不张消失。该病例表明,当RCC的EBM导致肺不张时,靶向治疗可能无需任何介入治疗即可重新开通阻塞的支气管。