Endobronchial metastases from a primary embryonal carcinoma

Abstract

We report the case of a 24-year-old man who presented with chief complaints of shortness of breath and haemoptysis; chest radiography revealed complete collapse of the left lung. Bronchoscopy revealed an endobronchial tumour with complete obstruction of the left main bronchus. Cryosurgical excision was performed; tissue pathology confirmed the diagnosis of metastatic embryonal carcinoma. The patient underwent a right orchiectomy followed by a bleomycin + etoposide + cisplatin (BEP) chemotherapy regimen.

Keywords: Cryosurgery; embryonal carcinoma; endobronchial metastases; endobronchial tumour.

Figure 1

Chest radiograph and bronchoscopic view of the endobronchial metastases (EBM). (A) Complete collapse of the left lung on chest radiograph. (B) Bronchoscopic view of the endobronchial tumour within the left main bronchus.

Figure 2

Tumour pathology of metastatic embryonal carcinoma. (A) Embryonal carcinoma with a complex glandular growth pattern. The characteristic large, cohesive, and highly pleomorphic tumour cells with moderate amounts of amphophilic cytoplasm, overlapping nuclei, vesicular chromatin, and frequent mitoses are shown (as indicated by the arrows; original magnification: 200×). (B) Immunohistochemical staining with anti‐thyroid transcription factor‐1 (TTF‐1) highlighting cells in the alveolar space (original magnification: 200×). (C) Immunohistochemical staining with anti‐sal‐like protein 4 (SALL4) revealed diffuse nuclear staining (original magnification: 200×). (D) Immunohistochemical staining with anti‐cluster of differentiation 30 (CD30) highlighting diffuse membranous staining (original magnification: 200×).