Endobronchial metastasis of osteosarcoma presenting as position-dependent and variable airway obstruction of the trachea.

Endobronchial metastasis secondary to osteosarcoma is distinctly rare. 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).