Treatment of bronchorrhea by corticosteroids in a case of bronchioloalveolar carcinoma producing CA19-9.

A case of gastrointestinal cancer-associated antigen (CA19-9)-positive bronchioloalveolar carcinoma accompanied by bronchorrhea and respiratory failure successfully treated with corticosteroids is reported. The patient was treated with pulse methylprednisolone at a dose of 1,000 mg/day for three days, followed by oral prednisolone (60 mg/day). Within 2 days, the sputum volume decreased from >100 ml/day to 20 ml/day and it was finally controlled to 0-10 ml/day. The reduction in the sputum volume was associated with alleviation of dyspnea and hypoxemia. The levels of CA19-9 in the serum and the sputum were extremely high and an immunocytochemical study showed that the tumor cells were stained by CA19-9 antibody. This case demonstrates the therapeutic value of corticosteroids in the treatment of bronchorrhea in subjects with bronchioloalveolar carcinoma.