Cavitating pulmonary metastases

Last revised by Rohit Sharma on 24 Oct 2024

Cavitating pulmonary metastases refer to pulmonary metastases which then tend to cavitate. The term is similar but may not be identical to cystic pulmonary metastases in which the wall of the former may be thicker.

Cavitation is thought to occur in around 4% of lung metastases 2.

Cavitary pulmonary metastases can come from the following primaries:

Cavitating pulmonary metastases have also been reported to develop after chemotherapy, thought to be secondary to tumor necrosis or a valve-effect on an adjacent bronchus 4,5

One particular complication that can occur includes the formation of a pneumothorax or a hemopneumothorax.

For multiple cavitating lung lesions (nodules or masses) on imaging consider:

Cases and figures

  • Figure 1: gross pathology
  • Case 1: likely cavitatory metastases
  • Case 2: from floor of mouth squamous cell carcinoma
  • Case 3: from rectal adenocarcinoma
  • Case 4: from melanoma
  • Case 5: from tongue squamous cell carcinoma
  • Case 6: from squamous cell lung cancer

Imaging differential diagnosis

  • Septic emboli
  • Pulmonary tuberculosis
  • Pulmonary necrobiotic nodules
  • Granulomatosis with polyangiitis
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