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Endobronchial metastasis secondary to osteosarcoma is distinctly rare.1 2 We report a young man with metastatic osteosarcoma who presented with position-dependent dyspnoea. A CT scan of the chest showed a soft tissue mass that originated from the left lung, causing significant volume loss of the left lung, extended through the left main bronchus and projected to the trachea (fig 1A,B). Bronchoscopy showed a tongue-like lesion that was noted to flip back and forth from the right main bronchus on inspiration to the main trachea on expiration (fig 1C,D and video). The patient underwent left-sided pneumonectomy and the pathology confirmed the diagnosis of metastatic osteosarcoma (fig 2).
The video was obtained during bronchoscopy as the patient was in the supine position. It demonstrates the variable position of the tongue-like lesion flipping back and forth from the right main bronchus on inspiration to the main trachea on expiration.
Provenance and Peer review Not commissioned; externally peer reviewed.