The patient in this report was a 73-year-old male who was diagnosed with small cell lung cancer (T3N0M0 stage IIB) after presenting with a 5.5 cm tumor detected in the right lower lobe of the lung by radiography. After right lower lobectomy and lymphadenectomy, postoperative adjuvant chemotherapy was administered with cisplatin and etoposide. At 27 months after surgery, the patient complained of wheezing. Tracheal metastasis was identified through computed tomography and bronchoscopy. Biopsy confirmed metastasis of small cell lung cancer. Radiotherapy (60 Gy) was administered to the mediastinal lymph nodes, including the supraclavicular region. The patient then underwent four cycles of carboplatin-etoposide-durvalumab, followed by durvalumab maintenance therapy. At 49 months after surgery, the patient complained of discomfort while speaking, leading to the discovery of a nodule in the subglottic space, which confirmed small cell lung cancer metastasis. Radiotherapy (30 Gy) was administered to the larynx and mediastinum, and the patient continued with durvalumab monotherapy. As of 61 months after surgery, he remains recurrence-free after the second course of radiotherapy. Our favorable outcome could be explained by the synergy between immunotherapy and radiotherapy. Here, we report a rare case of postoperative tracheal metastasis in small cell lung cancer successfully managed with radiotherapy and durvalumab. This shows promise in achieving local disease control and extending survival in postoperative metastatic lesions, highlighting a potential therapeutic approach.

BACKGROUND: The clinical feature, treatment and outcomes of the patients with endotracheal cancer after radical surgery for primary lung cancer are unclear. This article will provide a detailed explanation of the above issues by summarizing the relevant cases.
METHODS: We retrospectively reviewed five patients in Guangdong Provincial People\'s Hospital and retrieved 9 cases from other literatures by searching PubMed.
RESULTS: For five patients in out institute, 4 endotracheal cancers were considered as secondary to lung cancers. Radical stump resection (n=2), concurrent chemoradiotherapy (CCRT) (n=1), chemotherapy (n=1) and palliative care (n=1) were performed separately in 5 patients. The patient underwent CCRT achieved the longest progression-free survival of 29.5 months. For 9 patients retrieved from other studies, 8 endotracheal cancers were defined as metastases. Radiotherapy alone (n=4), CCRT (n=2), chemotherapy alone (n=2) or surgery (n=2) were performed separately in 10 lesions of 9 patients. 1 patient with radiotherapy alone and 1 patient with CCRT achieved complete response.
CONCLUSIONS: More attention should be paid to the abnormality of the trachea after surgery of lung cancer. CCRT may be a good choice for endotracheal cancers after primary lung cancer.
【中文题目：原发性肺癌术后继发或第二原发
气管内肿瘤：系列病例报道及文献综述】 【中文摘要：背景与目的 原发性肺癌根治术后出现继发或第二原发气管内肿瘤患者的临床特征、治疗手段及疗效、预后尚不清楚。本文将通过归纳总结相关病例，对以上问题进行详细阐述。方法 搜索广东省人民医院病历，筛选出5例肺癌术后出现气管肿物的患者，同时搜索PubMed从其他文献中筛选出9例病例。结果 本单位的5例患者中4例的气管内肿瘤被认为是继发于肺癌。在治疗方面，对这5例患者的气管内肿瘤分别进行了根治性切除术（n=2）、同步放化疗（concurrent chemoradiotherapy, CCRT）（n=1）、化疗（n=1）和姑息治疗（n=1）。接受CCRT治疗的患者获得最长的无进展生存期，为29.5个月。对于从其他文献中筛选到的9例患者，其中8例患者的气管内肿瘤被定义为转移。这9例患者的10个气管肿瘤分别进行了单独放疗（n=4）、CCRT（n=2）、单独化疗（n=2）和手术（n=2）。其中，1例单独接受放疗及1例接受CCRT的患者气管病灶均获得了完全缓解。结论 肺癌术后的患者出现气管内肿物应需引起足够重视。CCRT是原发性肺癌术后气管内新发肿瘤的有效治疗手段。
】 【中文关键词：肺肿瘤；继发性气管内肿瘤；第二原发性气管肿瘤；气管转移；气管癌；放疗；化疗】.

Cancer male breast is not very common. It comprises <1% of all breast cancers. Primary sites of metastasis are bone, brain, lung, and liver. Endobronchial and tracheal metastasis is very rare. To the best of our information, this is the first case of male breast carcinoma with upfront tracheal and endobronchial metastasis which presented as Superior vena cava obstruction (SVCO), initially evaluated on the lines of metastatic nonsmall-cell lung cancer. A 60-year-old gentleman presented with shortness of breath and features of SVCO. On primary evaluation, he was thought to be a case of nonsmall-cell lung cancer. Later on, it was confirmed to be carcinoma male breast with endobronchial and tracheal metastasis, which was reconfirmed with biopsy. The case we came across had symptoms associated with endobronchial metastases from primary extrapulmonary tumor and which was later found out to be breast. Treatment options are very different from lung primary and thus, we should be aware of the unusual disease presentation.

UNASSIGNED: Small Cell Lung Cancer (SCLC) is an aggressive malignancy with poor prognosis that accounts for 10% of all clinical lung cancer. SCLC commonly metastasizes to the mediastinum, liver, bone, adrenals, and the brain but secondary endotracheal metastasis is an especially rare occurrence. We discuss the case of a 74-year-old male with principal complaint of cough, wheezing and hemoptysis found to have secondary endotracheal lesions on bronchoscopy.
UNASSIGNED: A 74-year-old male, former smoker with a past medical history of pulmonary embolism, bullous emphysema, and limited stage small cell lung cancer with wedge resection and chemotherapy 3 years ago presented with cough, wheezing, weight loss and intermittent hemoptysis ongoing for few weeks. CT scan of the chest showed multiple polypoid masses arising in the anterior wall of the trachea. He underwent bronchoscopy with biopsy. Pathology was consistent with small-cell lung cancer.
UNASSIGNED: Secondary tracheal metastasis from early stage small cell cancer is a rare occurrence. The likelihood of tracheal metastasis of lung cancer is amplified when an endotracheal nodule or eccentric thickening of the tracheal wall is seen on CT of patients with high suspicion. It is important for clinicians to suspect endotracheal lesions when a patient presents with recurrent respiratory complaints despite stable surveillance CT scan of chest in patients with history of lung cancer.

暂无摘要。

Airway metastasis from primary lung carcinoma is rare and typically associated with non-small cell histology. While small cell lung cancer is a particularly aggressive form of cancer, few cases of endotracheal or endobronchial metastasis have been reported. Airway involvement can go undetected because of the spread along the perilymphatic drainage system with mostly submucosal involvement causing significant airway compromise before onset of symptoms. We present a patient with recurrent small cell lung cancer, presenting with wheezing, cough, and dyspnea as a result of metastasis to the trachea and bilateral bronchi without significant mediastinal or hilar lymphadenopathy. We discuss the related literature, as well as the suspected pathophysiology causing this unique presentation.

Tracheal metastases from renal cell carcinoma (RCC) are extremely rare. Most common primary malignancy metastasizing to this unusual location usually comes from lung region while it is rare to have tracheal metastases from nonpulmonary malignancies such as breast, thyroid, colorectal carcinoma, and melanoma. The lesions detected on fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) scan, especially in the head and neck region, soft tissue, and muscular compartment during follow-up of RCC patients raise the possibility of metastatic lesions in these regions, though rarely encountered. F-18 FDG PET/CT proved to be a valuable noninvasive imaging tool in detecting the very unusual distant metastases and multisystem involvement many years after nephrectomy in RCC in a single session in the present case.

Esthesioneuroblastoma is a rare tumour, for which a multimodal approach, including a combination of surgery and radiation, appears to provide the best disease-free and overall survival. Well-known for its tendency for local recurrence and distant spreading by both lymphatic and haematogenous routes, the most common sites of metastases are lungs and bones, followed by liver, spleen, scalp, breast, adrenals and ovary. One single case of metastasis to the trachea has been reported in the literature. The case is reported here of a patient who developed metastatic esthesioneuroblastoma to the trachea 18 months after primary surgery and radiation therapy. The patient was treated by two subsequent N-YAG laser endoscopic resections and chemotherapy.