Cavitating pulmonary metastases

Last revised by Joshua Yap on 1 May 2023

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 are most commonly (70%) caused by squamous cell carcinoma, which may of the lung or head and neck 1,4,6. Other primaries are varied and include:

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 bronchi 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:

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Cases and figures

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