title: Pulmonary metastasis of invasive thymoma, showing endobronchial polypoid growth: report of a case.
abstract: We report a rare case of pulmonary metastasis of invasive thymoma, with endobronchial polypoid growth causing hemosputum in a 77-year-old man. The patient had been admitted 8 years earlier for the treatment of invasive thymoma and had undergone extended thymo-thymectomy through a mid-sternotomy, followed by a course of radiotherapy. Pulmonary metastases developed 3 years after surgery, for which the patient received several courses of chemotherapy; however, the tumor continued to progress gradually. He presented at our emergency unit within 4 years of completion of the chemotherapy, with sudden massive hemoptysis. We performed endotracheal intubation to prevent suffocation and bronchoscopic examination revealed that a tumor and blood clots had obstructed the left main bronchus. We performed bronchial arterial embolization and endoscopic electrosurgery to resect the tumor, then occluded the responsible bronchus with an endobronchial Watanabe spigot to prevent further endobronchial polypoid growth and bronchial hemorrhage from the invasive thymoma.
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Tsukinowacho Seta Otsu, Shiga, 520-2192, Japan, kawaguchi1228@yahoo.co.jp.
authors.forename: Yo
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Jun
authors.initials: J
authors.lastname: Hanaoka
authors.forename: Koji
authors.initials: K
authors.lastname: Teramoto
authors.forename: Shoji
authors.initials: S
authors.lastname: Kitamura
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kaku
authors.forename: Keiko
authors.initials: K
authors.lastname: Ishida
authors.forename: Shoji
authors.initials: S
authors.lastname: Asakura
mesh_terms: D000368:Aged; D001981:Bronchial Arteries; D001984:Bronchial Neoplasms / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D004598:Electrosurgery / Q000379:methods; D004621:Embolization, Therapeutic; D004724:Endoscopy; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary* / Q000628:therapy; D008297:Male; D009361:Neoplasm Invasiveness; D011127:Polyps / Q000473:pathology* / Q000628:therapy; D013183:Sputum; D013934:Thymectomy; D013945:Thymoma / Q000150:complications / Q000556:secondary* / Q000601:surgery / Q000628:therapy; D013953:Thymus Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
references.citation: Respiration. 1995;62(5):294-6
references.pmid: 8560099
references.citation: Chest. 1988 Sep;94(3):647-9
references.pmid: 3409755
references.citation: N Engl J Med. 1950 Sep 28;243(13):478-82
references.pmid: 14775862
references.citation: J Natl Cancer Inst. 1990 Jan 3;82(1):4-6
references.pmid: 1688381
references.citation: Surg Today. 2011 Oct;41(10):1436-8
references.pmid: 21922373
references.citation: Nihon Hinyokika Gakkai Zasshi. 1996 Jan;87(1):1-12
references.pmid: 8683887
references.citation: Intern Med. 2001 Mar;40(3):227-31
references.pmid: 11310489