Bilateral Endobronchial Obstructive Metastases in a Patient with Colon Cancer: A Case Report

Although lung metastasis is frequent, endobronchial metastasis (EBM) is rare. We are presenting a case of colon cancer related bilateral EBM since it is rare. A sixty-two year old male patient was admitted with complaints of cough, respiratory distress and haemoptysis continuing for 3 months. He had a history of smoking 40 packages in a year, an operation due to colon cancer 12 years previously and adjuvant chemotherapy. Right pulmonary aeration was not observed in the direct pulmonary graphy, homogeneous opacity was detected in the right hemithorax and deviation to right was observed in the trachea. Fiberoptic bronchoscopy (FOB) revealed an endobronchial tumoral lesion obstructing the right main bronchus and tumoral lesions in the left main bronchus and the bronchus of the inferior left lobe. It was observed in an immunohistochemical study of the biopsy material, obtained from the mass within the right main bronchus, that the tumor sites were stained with CK20 and CDX2, and not stained with CK7 or TTF1. Histopathological findings were evaluated and found to be compatible with colon adenocarcinoma metastasis. Paliative 3600 cGY radiotherapy (RT) was performed on the right lung and mediastinum. FOLFIRI-Setuximab therapy was started since the metastatic colon cancer was of the K-ras wild type.

Kolon Kanseri Hastasýnda Bilateral Endobronþiyal Obstruktif Metastaz: Olgu Sunumu

Akciðer metastazý sýk olarak görülmesine raðmen, endobronþiyal metastaz (EBM) seyrektir. Kolon kanserine baðlý bilateral EBM nadir bir durum olmasý nedeniyle sunuldu. Altmýþiki yaþýnda erkek hasta, 3 aydýr olan öksürük, nefes darlýðý, hemoptizi þikayeleriyle baþvurdu. Kýrk paket yýl sigara kullanýmý, 12 yýl önce kolon kanseri nedeniyle operasyon ve adjuvan kemoterapi öyküsü mevcuttu. Direkt akciðer grafisinde sað akciðerde havalanma yoktu, sað hemitoraksta homogen opasite ve trakeada saða deviasyon vardý. Fiberoptik bronkoskopide (FOB) sað ana bronþu týkayan endobronþiyal tümöral lezyon ile sol ana bronþda ve sol alt lob bronþunda tümöral lezyon görüldü. Sað ana bronþdaki kitleden alýnan biyopsi materyalinin immunhistokimyasal çalýþýlmasýnda, tümöral alanlarýn CK20 ve CDX2 ile boyandýðý, CK7 ve TTF1 ile boyanmadýðý görüldü ve histopatolojik bulgular kolon adenokarsinom metastazý ile uyumlu olarak deðerlendirildi. Sað akciðer ve mediastene yönelik palyatif 3600 cGY radyoterapi (RT) uygulandý. Hastaya metastatik kolon kanseri ve K-ras wild tip olmasý nedeniyle FOLFÝRÝ-Setuksimab kemoterapisi baþlandý.