Endobronchial malignancy as a manifestation of advanced ovarian cancer recurrence: a case report and literature review.

Abstract

Background: Endobronchial metastasis from primary ovarian cancer (OC) is very rare. To enhance our understanding of this disease, we present a case report and retrospective analysis of a patient with a bronchial tumor as a manifestation of primary OC recurrence.

Case description: A 51-year-old woman presented with a history of intermittent cough and expectoration over 3 months by suffocating pneumonia for 3 weeks. Chest X-ray revealed multiple nodular masses at the right upper lobe, soft tissue thickening with bronchial invasion in the left upper lobe, enlargement of the right and left upper hilar, spreading mediastinum, and elevated right septum. Bronchoscopy identified stenosis in the right main bronchus opening with obstruction of the apical, middle, and posterior segmental bronchi in the opening of left main bronchus by a visible neoplasm. Biopsy of the endobronchial lesion was akin to metastatic OC. Indeed, the patient was previously treated for advanced OC with enlarged left supraclavicular nodules [International Federation of Gynecology and Obstetrics (FIGO) stage 4B]. The treatment includes surgical resection of the uterus, fallopian tubes, ovaries, omentum, and left supraclavicular lymph nodes, as well as chemotherapy before and after surgery. Unfortunately, further chemotherapy was discontinued due to intolerance. Rapid disease progression occurred leading to her late self-referral and admission, decision for palliation, ultimately resulting in her demise.

Conclusions: Flexible bronchoscopy combined with imaging and immunohistochemistry tests proves to be an effective diagnostic strategy for identifying endobronchial metastasis in OC patients. Endobronchial intervention, radiotherapy, and chemotherapy emerge as viable treatment modalities for these patients. The prognosis of OC patients with an endobronchial metastasis as a manifestation of recurrent disease should be considered in the context of their advanced disease despite available active treatment modalities.