Endobronchial metastasis of osteosarcoma presenting as position-dependent and variable airway obstruction of the trachea Endobronchial metastasis secondary to osteosarcoma is distinctly rare. 1 2 We report a young man with metastatic osteosarcoma who presented with position-dependent dyspnoea. A CT scan of the chest showed a soft tissue mass that originated from the left lung, causing significant volume loss of the left lung, extended through the left main bronchus and projected to the trachea

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... fig 1A,B) . Bronchoscopy showed a tongue-like lesion that was noted to flip back and forth from the right main bronchus on inspiration to the main trachea on expiration (fig 1C,D and video) . The patient underwent left-sided pneumonectomy and the pathology confirmed the diagnosis of metastatic osteosarcoma (fig 2) . VIDEO The video was obtained during bronchoscopy as the patient was in the supine position. It demonstrates the variable position of the tongue-like lesion flipping back and forth from the right main bronchus on inspiration to the main trachea on expiration.