Metastatic lesions from nonpulmonary neoplasms can involve the airways and frequently cause symptomatic airway obstruction. Several endobronchial therapeutic interventions are available that use either a rigid or flexible bronchoscope. We evaluated the use of endobronchial electrocautery (EC) via flexible bronchoscopy (FB) in patients with airway obstruction caused by metastases from nonpulmonary malignancies. This is a retrospective review of 13 consecutive patients who presented with symptomatic airway obstruction caused by metastasis from a nonpulmonary malignancy between April 1999 and October 2004. A total of 26 procedures were performed for 41 obstructive lesions. The indications for bronchoscopic examination were atelectasis (11), hemoptysis (8), or both (7). Renal cell carcinoma was the primary carcinoma in 6 patients, melanoma in 2 patients, and breast, bladder, ovary, epiglottis, and uterine carcinoma, 1 in each of the remaining 5 patients. The majority of procedures (15) were performed on outpatients. Twelve procedures were performed on inpatients, of which 3 were intubated. All procedures used endobronchial EC via FB. One procedure also included balloon dilation after endobronchial EC. A complete response was achieved after 7 EC procedures and a partial response after 15 procedures, resulting in an overall response rate of 85%. There were no procedure-related fatalities, but moderate bleeding was encountered during 3 procedures (12%) in 2 patients. Endobronchial EC using an FB is a safe, effective, and relatively inexpensive palliative therapy in patients with symptomatic airway obstruction due to metastases from nonpulmonary malignancies.
- Airway obstruction
- Bronchial neoplasms
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine