We report the case of a 77-year-old woman with a history of arterial hypertension and left hemithyroidectomy for multinodular hyperplasia. The patient consulted with a 1-month history of dyspnea. Chest X-ray showed complete atelectasis of the left lung, and CT revealed an image of soft tissue in the left main bronchus (LMB) (Fig. 1A) causing complete pulmonary atelectasis, and bilateral pulmonary nodules. Fiberoptic bronchoscopy showed a rounded endobronchial lesion, 3.5 cm from the carina, completely occluding the LMB (Fig. 1B). Biopsies were negative for malignancy, while the microbiological culture was positive for Aspergillus fumigatus. Given the suspicion of metastatic disease, bronchoscopy was repeated with aspiration of a left pulmonary nodule that did not yield a firm diagnosis. Finally, rigid bronchoscopy was performed, and the mass could be completely resected, resulting in a patent airway with reexpansion of the lung. Pathology testing reported oncocytic tumor of thyroid origin.
Endobronchial metastases have been described in 2.6% of thyroid carcinomas.1 In this case, the metastasis appeared 2 years after removal of part of the thyroid, with no histological evidence of malignancy. Although diagnosis is made from endoscopy, fiberoptic bronchoscopy may be inconclusive in some cases,2 and rigid bronchoscopy may be needed to achieve a correct diagnosis.
Please cite this article as: Rodríguez Alvarado I, et al. Metástasis endobronquial de carcinoma tiroideo oculto. Arch Bronconeumol. 2019;55:648.
