Métastases intrathoraciques

Abstract

Pulmonary metastasis are the most frequent pulmonary malignant lesions. They have a prevalence of 30 to 50% in patients with thoracic or extrathoracic malignancies, this being related with the role of vascular filter of the lung parenchyma. Primary malignancies most often concerned are pulmonary, breast, colonic, pancreatic, kidney, gastric, ENT carcinoma and melanoma. Pleural metastasis represent 95% of malignant diseases of the pleura. Pulmonary, breast, ovarian or gastric adenocarcinoma are most often concerned. Lymphoma may also involve the pleura with possible multifocal localizations and represent a differential diagnosis. Knowledge of mechanisms of drainage and migration of tumoral cells initial site explains the various patterns of lung metastasis. Computed tomography is the best imaging toll for the diagnosis and post-therapeutic follow-up of pulmonary metastasis. In this context of disseminated disease, chemotherapy increases the survival. Surgery may be proposed when disease is localized to the lung and stabilized by chemotherapy. Cases of cure have however been reported after surgery of colonic metastasis without previous chemotherapy.