Cavitating pulmonary metastases

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Disclosures - updated 16 Jan 2023:

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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.

Epidemiology

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

Pathology

Cavitary pulmonary metastases ~~are most commonly (70%) caused by~~ can come from the following primaries:

squamous cell carcinoma~~, which may of the~~ (70%): lung or head and neck primary ^1,4,6~~. Other primaries are varied and include:~~
adenocarcinoma: gastrointestinal ~~adenocarcinomas~~tract, breast ^64,6

sarcoma ⁴

transitional cell carcinoma of bladder ³
~~sarcomas~~ ⁴
cervical cancer ⁷
pancreatic adenocarcinoma⁸: very rare⁸

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

Treatment and prognosis

Complications

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

Differential diagnosis

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

septic pulmonary emboli
granulomatosis with polyangiitis
necrobiotic lung nodules: rare
pulmonary tuberculosis: upper lobe predominant consolidative region with cavitation

-<p><strong>Cavitating pulmonary metastases</strong> refer to <a href="/articles/pulmonary-metastases">pulmonary metastases</a> which then tend to cavitate. The term is similar but may not be identical to <a href="/articles/cystic-pulmonary-metastases">cystic pulmonary metastases</a> in which the wall of the former may be thicker.</p><h4>Epidemiology</h4><p>Cavitation is thought to occur in around 4% of lung metastases <sup>2</sup>.</p><h4>Pathology</h4><p>Cavitary pulmonary metastases are most commonly (70%) caused by squamous cell carcinoma, which may of the <a href="/articles/squamous-cell-carcinoma-of-the-lung">lung</a> or <a href="/articles/head-and-neck-squamous-cell-carcinoma-overview">head and neck</a> <sup>1,4,6</sup>. Other primaries are varied and include:</p><ul>
~~-<li><p>gastrointestinal adenocarcinomas <sup>6</sup></p></li>~~
~~-<li><p><a href="/articles/transitional-cell-carcinoma-urinary-bladder">transitional cell carcinoma of bladder</a> <sup>3</sup></p></li>~~
~~-<li><p>sarcomas <sup>4</sup></p></li>~~
~~-<li><p><a href="/articles/carcinoma-of-the-cervix">cervical cancer</a> <sup>7</sup></p></li>~~
~~-<li><p><a href="/articles/pancreatic-adenocarcinoma">pancreatic adenocarcinoma</a> <sup>8</sup>: very rare </p></li>~~
-</ul><p>Cavitating pulmonary metastases have also been reported to develop after chemotherapy, thought to be secondary to tumour necrosis or a valve-effect on an adjacent bronchi <sup>4,5</sup>. </p><h4>Treatment and prognosis</h4><h5>Complications</h5><p>One particular complication that can occur includes the formation of a <a href="/articles/pneumothorax">pneumothorax</a> or a <a href="/articles/haemopneumothorax">haemopneumothorax</a>.</p><h4>Differential diagnosis</h4><p>For multiple cavitating lung lesions (nodules or masses) on imaging consider:</p><ul>
~~-<li><p><a href="/articles/septic-pulmonary-emboli">septic pulmonary emboli</a></p></li>~~
~~-<li><p><a href="/articles/granulomatosis-with-polyangiitis">granulomatosis with polyangiitis</a></p></li>~~
~~-<li><p><a href="/articles/necrobiotic-pulmonary-nodules">necrobiotic lung nodules</a>: rare</p></li>~~
~~-<li><p><a href="/articles/tuberculosis-pulmonary-manifestations-1">pulmonary tuberculosis</a>: upper lobe predominant consolidative region with cavitation</p></li>~~
+<p><strong>Cavitating pulmonary metastases</strong> refer to <a href="/articles/pulmonary-metastases">pulmonary metastases</a> which then tend to cavitate. The term is similar but may not be identical to <a href="/articles/cystic-pulmonary-metastases">cystic pulmonary metastases</a> in which the wall of the former may be thicker.</p><h4>Epidemiology</h4><p>Cavitation is thought to occur in around 4% of lung metastases <sup>2</sup>.</p><h4>Pathology</h4><p>Cavitary pulmonary metastases can come from the following primaries:</p><ul>
+<li><p>squamous cell carcinoma (70%): lung or head and neck primary <sup>1,4,6</sup></p></li>
+<li><p>adenocarcinoma: gastrointestinal tract, breast <sup>4,6</sup></p></li>
+<li><p>sarcoma <sup>4</sup></p></li>
+<li><p><a href="/articles/transitional-cell-carcinoma-urinary-bladder">transitional cell carcinoma of bladder</a> <sup>3</sup></p></li>
+<li><p><a href="/articles/cervical-carcinoma-1">cervical cancer</a> <sup>7</sup></p></li>
+<li><p><a href="/articles/pancreatic-adenocarcinoma">pancreatic adenocarcinoma</a>: very rare <sup>8</sup> </p></li>
+</ul><p>Cavitating pulmonary metastases have also been reported to develop after chemotherapy, thought to be secondary to tumour necrosis or a valve-effect on an adjacent bronchus <sup>4,5</sup>. </p><h4>Treatment and prognosis</h4><h5>Complications</h5><p>One particular complication that can occur includes the formation of a <a href="/articles/pneumothorax">pneumothorax</a> or a <a href="/articles/haemopneumothorax">haemopneumothorax</a>.</p><h4>Differential diagnosis</h4><p>For multiple cavitating lung lesions (nodules or masses) on imaging consider:</p><ul>
+<li><p><a href="/articles/septic-pulmonary-emboli">septic pulmonary emboli</a></p></li>
+<li><p><a href="/articles/granulomatosis-with-polyangiitis">granulomatosis with polyangiitis</a></p></li>
+<li><p><a href="/articles/necrobiotic-pulmonary-nodules">necrobiotic lung nodules</a>: rare</p></li>
+<li><p><a href="/articles/tuberculosis-pulmonary-manifestations-1">pulmonary tuberculosis</a>: upper lobe predominant consolidative region with cavitation</p></li>

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