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Endobronchial metastasis as an uncommon pattern of metastatic dissemination from small cell osteosarcoma
  1. Arun Kadamkulam Syriac1,
  2. Amrit Ved Bhaskarla1,
  3. Mohamed Elrifai2 and
  4. Abdul Hamid Alraiyes3,4
  1. 1 Internal Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
  2. 2 Cleveland Clinic, Cleveland, Ohio, USA
  3. 3 Cancer Treatment Centers of America Chicago, Zion, Illinois, USA
  4. 4 Pulmonary Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
  1. Correspondence to Dr Arun Kadamkulam Syriac, drsyriac{at}


Endobronchial metastasis (EBM) from extrapulmonary primary malignancy is a rare entity. Although the most common site of metastasis of osteosarcoma is the lungs, EBM remains a rare occurrence. Cough and dyspnea are the most common symptoms. A significant number of patients are asymptomatic, making the diagnosis without any radiographic imaging challenging. CT scan of the lung, along with bronchoscopy and biopsy, is the mainstay of diagnosis and staging. A 36-year-old man presented with small cell osteosarcoma of the left maxillary region and was treated with surgery and adjuvant chemotherapy. The patient presented 8 years later with axillary metastasis and was found to have lung metastasis on further workup. Bronchoscopy and biopsy proved an EBM that was debulked by hot snare technique. The patient was then started on chemotherapy for recurrent small cell osteosarcoma.

  • lung cancer (oncology)
  • respiratory cancer
  • head and neck cancer
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  • Contributors AKS did ground work including collecting images and writing up the case. AVB contributed by writing up the case and in the literature search as well as making revisions as necessary. ME drafted and reviewed the case report, along with contributions to the discussion part of the case. AHA identified the case, reviewed the case report and made significant changes along with given expert opinions on the subject.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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