Endobronchial metastasis of fibrosarcoma successfully managed via rigid bronchoscopy.

Abstract

This case report describes a 60-year-old female with a history of high-grade epithelioid myxofibrosarcoma, initially diagnosed in the right gluteal region. After resection, she experienced a recurrence at the same site, treated with radiotherapy. Fifteen months post-diagnosis, she developed pulmonary metastasis, confirmed by positron emission tomography-computed tomography (PET-CT). Surgical resection of the nodules via video-assisted thoracoscopic surgery (VATS) showed clear margins. Three months later, the patient presented with respiratory distress and rapidly deteriorated due to a mass occluding the right main bronchus, leading to complete lung collapse. Emergency bronchoscopy successfully excised the mass, revealing intact bronchial architecture. Following the procedure, she began treatment with larotrectinib, resulting in significant clinical improvement and enhanced lung aeration on follow-up imaging. This case highlights the importance of monitoring for airway obstruction in malignancy patients and the effectiveness of bronchoscopy in managing such complications.