Adjuvant Treatment of Proper Endobronchial Management in Leiomyosarcoma
A 38-year-old female visited our emergency room complaining of worsening dyspnea and blood-tinged sputum. She had undergone a total hysterectomy for a uterine mass 5 years earlier. Chest radiography revealed multiple masses of various sizes in both lungs, suggesting pulmonary metastases. Chest CT revealed an elongated bronchial lesion in the left main bronchus, almost obstructing it. Abdominal CT revealed an 8.8-cm enhancing soft tissue mass with adjacent bone destruction at the sacrum, suggesting bone metastasis. Further evaluation including a biopsy was performed, and leiomyosarcoma with metastasis to lung, bone, heart, and brain was diagnosed.\nThe dyspnea worsened despite a first cycle of chemotherapy. Chest radiography revealed increased opacity of the left hemithorax, suggesting atelectasis (). Bronchoscopy revealed an encapsulated pedunculated mobile mass in the proximal left main bronchus (). Recanalization of the left main bronchus was performed using a flexible bronchoscope with cryoextraction (). A 6-cm mass was extracted from the left main bronchus (). The dyspnea was relieved and improvement of the atelectasis was observed on chest radiography (). Subsequently, the planned chemotherapy could be performed.