Endobronchial metastasis from basal cell skin cancer.

Case Report A 59-year-old woman, non-smoker, housewife, was admitted to the Pulmonary Department in August 1992 with fever, cough and haemoptysis. She had similar episodes over the previous 6 months which were resolved with antibiotic treatment. Three years earlier an ulcerated skin lesion was observed in the left axillary area. The lesion was surgically excised and histologic examination disclosed adenoid basal cell carcinoma (BCC). One year later recurrence was evident in the same region and a second and more extensive surgical intervention with amputation of the left arm was attempted because of perineural and perivascular invasion. The patient remained well for 18 months when pneumonia in the left lower lobe was diagnosed. On examination, the patient was an obese woman, with complete amputation of the left arm, who appeared ill. Her temperature’ was 3%4”C, blood pressure 120/80 mmHg, heart rate 95 beats min ~ ’ and respirations 20 min ~ ‘. The surgical scar showed no ulcerations and no lymph nodes were palpable. The rest of the clinical examination was negative, except for rales on auscultation of the posterior of the lower left hemithorax.