Endoscopic Debulking in the Management of Osteosarcoma With a Rare Endobronchial Metastasis

Osteosarcoma most commonly metastasizes to the lung, which requires individualized management based on the location of the disease. Surgical resection has been the cornerstone to improving outcomes in peripheral metastatic lung disease. However, central airway obstruction is rare, resulting in limited evidence regarding the optimal management of this manifestation. We report a case of a 68-year-old man with osteosarcoma and bilateral lung metastasis. A 10 centimeter tumor on the right involved the hilum with extension to the pleura. Bronchoscopy confirmed an endobronchial mass occluding the bronchus intermedius. This central airway tumor was debulked via endoscopy and later managed medically with chemotherapy. This case describes a rare manifestation of osteosarcoma metastasis and the multidisciplinary management to control tumor burden.