Endobronchial Extension of Metastatic Osteosarcoma Causing Central Airway Obstruction: A Case Report.
4 affiliations
- 1Division of Pulmonary and Critical Care Medicine Department of Internal Medicine University of Tennessee Medical Center Knoxville Tennessee USA tennessee.edu.
- 2Department of Internal Medicine University of Tennessee Medical Center Knoxville Tennessee USA tennessee.edu.
- 3Department of Pathology University of Tennessee Medical Center Knoxville Tennessee USA tennessee.edu.
- 4Division of Thoracic Surgery Department of Surgery University of Tennessee Medical Center Knoxville Tennessee USA tennessee.edu.
Abstract
Metastatic osteosarcoma most commonly involves the lungs and typically presents as peripheral pulmonary nodules amenable to limited resection. Endobronchial extension of metastatic osteosarcoma resulting in critical central airway obstruction, however, is rare. We present a woman in her late 60s with a history of distal femoral osteosarcoma treated 15 years earlier who developed progressive respiratory symptoms initially treated as pneumonia. Imaging demonstrated a large right-sided endobronchial mass causing obstruction of the right mainstem bronchus and impending compromise of the left mainstem bronchus. Urgent flexible bronchoscopy was performed with rigid bronchoscopy and extracorporeal membrane oxygenation available on standby as rescue measures. Tumor debulking using hot snare resection and forceps restored ventilation to the left lung and stabilized the airway. Because of extensive hilar and endobronchial involvement, definitive surgical management required right pneumonectomy via a serratus-sparing posterolateral thoracotomy. Pathologic examination demonstrated a 14.5-cm metastatic osteosarcoma originating in the right middle lobe with negative bronchial, vascular, and parenchymal margins and no lymph node involvement. The patient recovered without major complications. This case highlights a rare presentation of metastatic osteosarcoma causing life-threatening central airway obstruction and demonstrates the importance of multidisciplinary management, bronchoscopic airway stabilization, and definitive surgical resection in carefully selected patients.
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BibTeX
@article{dasgupta2026endobronchial,
title = {{Endobronchial Extension of Metastatic Osteosarcoma Causing Central Airway Obstruction: A Case Report.}},
author = {Mona Dasgupta and Jesse Woodall and Whitney Brinkley and Christina Glenn and Christian Probst and Paul Branca and Benjamin Bevill and Sean Jordan},
journal = {Case reports in surgery},
year = {2026},
month = oct,
doi = {10.1155/cris/8255987},
url = {https://europepmc.org/article/MED/42910191},
note = {CC BY},
}
RIS
TY - JOUR
TI - Endobronchial Extension of Metastatic Osteosarcoma Causing Central Airway Obstruction: A Case Report.
AU - Mona Dasgupta
AU - Jesse Woodall
AU - Whitney Brinkley
AU - Christina Glenn
AU - Christian Probst
AU - Paul Branca
AU - Benjamin Bevill
AU - Sean Jordan
PY - 2026
DA - 2026/10/21
JO - Case reports in surgery
DO - 10.1155/cris/8255987
UR - https://europepmc.org/article/MED/42910191
AB - Metastatic osteosarcoma most commonly involves the lungs and typically presents as peripheral pulmonary nodules amenable to limited resection. Endobronchial extension of metastatic osteosarcoma resulting in critical central airway obstruction, however, is rare. We present a woman in her late 60s with a history of distal femoral osteosarcoma treated 15 years earlier who developed progressive respiratory symptoms initially treated as pneumonia. Imaging demonstrated a large right-sided endobronchial mass causing obstruction of the right mainstem bronchus and impending compromise of the left mainstem bronchus. Urgent flexible bronchoscopy was performed with rigid bronchoscopy and extracorporeal membrane oxygenation available on standby as rescue measures. Tumor debulking using hot snare resection and forceps restored ventilation to the left lung and stabilized the airway. Because of extensive hilar and endobronchial involvement, definitive surgical management required right pneumonectomy via a serratus-sparing posterolateral thoracotomy. Pathologic examination demonstrated a 14.5-cm metastatic osteosarcoma originating in the right middle lobe with negative bronchial, vascular, and parenchymal margins and no lymph node involvement. The patient recovered without major complications. This case highlights a rare presentation of metastatic osteosarcoma causing life-threatening central airway obstruction and demonstrates the importance of multidisciplinary management, bronchoscopic airway stabilization, and definitive surgical resection in carefully selected patients.
SN - 2090-6900
SN - 2090-6919
ER -