Endobronchial Metastasis from Primary Chest Wall Leiomyosarcoma: A Rare Pattern of Recurrence

This is the authors' abstract. We don't add key points for this paper.

Leiomyosarcomas are a type of soft tissue tumor. They have a low incidence and can arise in any part of the body, commonly arising in the intrabdominal viscera. They have unique metastatic characteristics. Here we discuss the case of a 54-year-old hypertensive man who presented initially with a right sided anterior chest wall mass. Investigations confirmed it to be a chest leiomyosarcoma. He was treated with surgical resection and reconstruction along with adjuvant radiotherapy. Ten months later, he presented again with complaints of large volume hemoptysis. Workup showed that the patient had developed a metastatic lesion in the right main bronchus. Endobronchial biopsy and EBUS-TBNA confirmed metastatic leiomyosarcoma. From our literature review and knowledge, we conclude that this is the first reported case of a leiomyosarcoma metastasizing to the endobronchial region. The discussion explores the novelty of this metastatic pathway, diagnostic challenges, and the importance of bronchoscopy and multidisciplinary care in guiding surveillance and palliation.