Bronchoscopic aspects of renal cell carcinoma (RCC).

A symposium on RCC in July 1998 in Tübingen was where we to reviewed our patients with endobronchial metastatic RCC treated by bronchoscopy since 1981. 24 of 26 consecutive cases are the subject of the present study. Tumor history, X-ray findings, endobronchial appearance, treatment and the pathogenetic mechanisms of this special form of metastatic spread are demonstrated and discussed. In 5 patients > 10 years relapsed between nephrectomy and bronchoscopic tumor therapy. A thrombuslike tumor growth and bleeding were striking bronchoscopic features. In X-ray besides atelectasis, hilar or mediastinal masses were seen half of the patients, in 50% without parenchymal lung nodes, suggesting lymphogenic spread. In several patients bronchial recanalisation could be successfully repeated over long periods. Abnormal X-ray, haemoptysis or dyspnoa in patients with RCC demands bronchoscopy. In case of bronchial tumor obstruction bronchoscopic treatment offers excellent palliation.