Severe bronchorrhea in a patient with bronchioloalveolar carcinoma.
Mucinous bronchioloalveolar carcinoma (BAC) can be associated with significant bronchorrhea. A 46-year-old man presented with BAC with 2,000 mL of sputum production on a daily basis, which prevented him from being extubated. As this condition is rare, there are only case reports outlining the therapy for the associated bronchorrhea. We used azithromycin, scopolamine, and inhaled fluticasone with moderate success. The initiation of an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, gefitinib, resulted in dramatic improvement in the volume of pulmonary secretions produced. The patient's EGFR mutation status was subsequently found to be negative, which supports the hypothesis that the mechanism of reduction of bronchorrhea is independent of the antiproliferative effect of the drug.
Department of Medicine, McMaster University, Hamilton, ON, Canada. Electronic address: nooreen.popat@medportal.ca.
Nooreen
N
Popat
Department of Internal Medicine, Kingston General Hospital, Kingston, ON, Canada.
Natya
N
Raghavan
Department of Medicine, McMaster University, Hamilton, ON, Canada.
R Andrew
RA
McIvor
D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D001706:Biopsy; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011799:Quinazolines / Q000627:therapeutic use*; D013183:Sputum / Q000378:metabolism; D014057:Tomography, X-Ray Computed
D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000077156:Gefitinib