Endobronchial metastasis from primary anorectal melanoma

Abstract

Patient: Male, 64Final Diagnosis: Metastatic anorectal melanoma with endotracheal metastasisSymptoms: Fatigue • weight loss • hematochezia • coughMedication: NoneClinical Procedure: Biopsy of anal mass • rigid bronchoscopySpecialty: Internal medicine • oncology • pulmonologyObjective:Rare diseaseBackground:Anorectal melanoma is a rare cancer with a poor prognosis. The mean survival after diagnosis is 15–25 months. At the time of diagnosis, 61% of patients have local regional lymph node metastases, and 21% have distant metastases. The lungs are a common site for metastasis for all tumors including melanoma. However endobronchial metastasis is a rare phenomenon. Endotracheal metastases are even rarer, occurring in only 5% of patients with extrapulmonary endobronchial metastases. It is most commonly seen in breast, colorectal, and kidney cancers. It is extremely rare for cutaneous melanoma. The mean survival after diagnosis is only 15 months and treatment options are limited.Case Report:We report the case of a 64 year-old gentleman with newly diagnosed metastatic anorectal melanoma. A 3 cm by 3 cm bluish-black, oval-shaped, exophytic mass protruding from his anus was found on physical exam. Endobronchial and endotracheal metastasis to the trachea were discovered on computed tomography and he was subsequently taken to the operating room for argon plasma coagulation laser recanalization of his trachea via rigid bronchoscopy, and resection of his anal mass.Conclusions:We have presented the first known case of anorectal melanoma with endobronchial metastasis. Palliative APC laser recanalization was used to prevent asphyxiation from the endotracheal mass. Endobronchial metastasis is uncommon and can be easily mistaken for primary bronchogenic carcinoma. It should always be considered when evaluating patients with new lung masses.

Circulating miR-221 Expression Level and Prognosis of Cutaneous Malignant Melanoma

“…Cutaneous malignant melanoma (CMM) originates from melanocytes and is a highly aggressive disease, accounting for 80% of deaths arising from skin cancer worldwide [ 1 ]. CMM is highly characteristic of aggressive invasion, early metastasis, and resistance to chemotherapy or radiotherapy, which results in increased incidence and mortality worldwide [ 2 , 3 ]. Despite improvements in early CMM diagnosis, the 5-year survival rate for patients with advanced disease is still very low [ 4 ].…”

Endobronchial Valves in Treatment of Persistent Air Leaks: A Systematic Review of Clinical Evidence

“…The principles of conservative management of air leaks include air drainage by the use of chest tubes and treatment of infection and nutrition deficits [ 5 ]. Currently, with the evolution of endoscopic methods [ 6 , 7 ], the endobronchial management of air leaks has become an alternative therapy to treat persistent air leaks. Interventional bronchoscopy may be a valuable alternative in the treatment of BPFs, especially at distal tracts of the bronchial tree, and could be an ideal therapeutic option for high-risk patients.…”

Adjuvant Treatment of Proper Endobronchial Management in Leiomyosarcoma

“…Several studies have reported that the effect of interventional bronchoscopy for endobrochial metastases from malignant neoplasm, resolving endometrial metastases from colorectal cancer 5 , small cell lung cancer 6 , renal cell carcinoma 7 , anorectal melanoma 8 and hypernephroma 9 . However, there is little information about interventional bronchoscopy for endobronchial metastasis from advanced leiomyosarcoma.…”