Endobronchial Submucosal Lymphangitic Metastasis from Papilla of Vater Carcinoma

Background; Endobronchial metastasis (EBM) from extrapulmonary neoplasms is rare. Variable-sized nodules are typical radiologic fea­tures, whereas submucosal lymphangitic carcinoma is an uncom­mon involvement.

Case description and results: We present a pa­tient who had pancreatico-duodenectomy five months previously for Vater’s papilla cancer. She had respiratory symptoms with bilateral lung infiltrations and diffuse thickening of the interstitium, representing lymphangitic metastasis, radiologically. Bronchoscopic findings dem­onstrated submucosal spreading of the tumor. Histological studies re­sulted in diagnosis of metastatic adenocarcinoma of pancreatic origin.

Conclusion: To our knowledge, this is the first case in the literature with endobronchial submucosal lymphangitic metastasis of Vater’s papilla cancer. This tumor may be considered in the differential diag­nosis of endobronchial metastasis. Also, in light of this case report, patients with Vater’s papilla cancer should be evaluated for endobron­chial metastasis if there are respiratory symptoms, for staging of the primary tumor.