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While most lung spread presents as parenchymal disease, endobronchial metastases have been reported. The case describes papillary thyroid cancer presenting with endobronchial lesions, managed through Aragon Plasma Coagulation. Treatment focuses on controlling endobronchial involvement when standard diagnostic steps are limited.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/papillary-thyroid-cancer-with-endobronchial-metastasis-managed-with-aragon-plasma-coagulation-a-case-report/411580/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/papillary-thyroid-cancer-with-endobronchial-metastasis-managed-with-aragon-plasma-coagulation-a-case-report/411580.png","ImageObject",300,407,{"name":92,"@type":93},"Mabel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"How was the patient’s papillary thyroid cancer initially managed after diagnosis?","Question",{"text":113,"@type":114},"She underwent total thyroidectomy and received radioactive iodine (150 mCi) in 1997. Subsequent imaging and thyroglobulin monitoring were used to follow disease status.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Why was bronchoscopy performed in the operating room?",{"text":118,"@type":114},"A diagnostic bronchoscopy attempt was not tolerated, and the multidisciplinary team later decided on bronchoscopy in the operating room due to high risk.",{"name":120,"@type":111,"acceptedAnswer":121},"What intervention was used to treat the endobronchial lesions?",{"text":122,"@type":114},"Aragon plasma coagulation was applied to both endobronchial lesions during bronchoscopy, aiming to control the endobronchial metastatic disease.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},411580,1790716941,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},7971474920318,"https://ap-avatar.wpscdn.com/avatar/74000ee537e6b0ca360?x-image-process=image/resize,m_fixed,w_180,h_180&k=1788430171632181674","Respiratory Medicine Case Reports 59 (2026) 102338  \nContents lists available at ScienceDirect  \nRespiratory Medicine Case Reports  \njournal [homepage:](homepage: www.elsevier.com/locate/rmcr)[ www.elsevier.com/locate/rmcr](homepage: www.elsevier.com/locate/rmcr)  \n| Case Report\u003Cbr>Papillary thyroid cancer with endobronchial metastasis managed with Aragon plasma coagulation: A case report\u003Cbr>*\u003Cbr>Amjad Altalla , Muhannad Hawari , Abdulaziz Almogbil\u003Cbr>King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia |\n| --- |\n| A B S T R A C T |\n| Papillary Thyroid cancer is a slow growing neoplasm with a low risk for metastasis. Metastasis to the respiratory system is common, but is usually parenchymal with some cases of metastasis presenting as endobronchial lesions reported. We report a case of PTC presenting with endobronchial lesions managed by intervention with Aragon Plasma Coagulation. |\n\n1. introduction  \nThyroid cancer is the most common endocrine tumor worldwide and typically presents a moderate risk of death. The median age of thyroid cancer diagnosis in Saudi Arabia is 35–39 years. The median mortality age is 45–49 years, compared with a global figure of 60–64 years, with papillary thyroid cancer being the most common type [1].  \nPapillary thyroid cancer is generally considered a slowly growing neoplasm and risk of metastasis is thought to be low. 2–10 % of patients have metastases beyond the neck at the time of diagnosis. Among such patients, two-thirds have pulmonary and one-fourth have skeletal metastases. Rarer sites of metastasis are the brain, kidneys, liver, and adrenals [2].  \n2. Case report  \nThis is a 61-year-old female with papillary thyroid carcinoma and lung metastasis. She was diagnosed in 1997. She underwent total thyroidectomy and received radioactive iodine 150 mCi in the same year. In the subsequent visit, she was found to have negative whole body scan but increased TG level. In 2003, she underwent left lung metastasectomy for lung masses, and histopathology showed papillary thyroid cancer. The repeated CT scan in October 2004 showed no recurrent lesion. She received the second dose of radioactive iodine 212 mCi in April 2004 for negative scan and positive thyroglobulin of 237. In January 2008, neck ultrasound showed anew hypoechoic nodule measuring 1 cm suspected for metastasis and fine needle aspiration showed papillary thyroid cancer. Subsequently, she underwent bilateral neck dissection in August 2008, and histopathology showed papillary thyroid carcinoma. The whole-body scan in November 2008 was negative. TSH was 96 mU/L, antibodies less than 10 U/mL and thyroglobulin 401 μg/L. CT scan in February 2012 showed recurrence of thyroid cancer in neck. She underwent bilateral neck dissection in the same month, and histopathology showed papillary thyroid carcinoma. PET CT scan in October 2012 showed FDG avid disease in the neck and interval progression of the FDG avid in bilateral pulmonary nodules. The patient was planned for external radiation therapy. She received external radiation therapy for six weeks completed February 2013.  \nThe repeated ultrasound in March 2013 showed a small hypoechoic hypovascular nodule in the right thyroid bed and another hypoechoic hypovascular nodule in the left thyroid bed. The whole-body scan was negative with TSH of 57.3 mU/L, TG of 389.7 μg/L  \n* Corresponding author.  \n[E-mail address:](E-mail address: MHawari@kfsrc.edu.sa)[ MHawari@kfsrc.edu.sa](E-mail address: MHawari@kfsrc.edu.sa) (M. Hawari).  \n[https://doi.org/10.1016/j.rmcr.2025.102338](https://doi.org/10.1016/j.rmcr.2025.102338)  \nReceived 29 July 2025; Accepted 29 November 2025  \nAvailable online 2 December 2025  \n2213-0071/© 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)).  \nA. Altalla et al. Respiratory Medicine Case Reports 59 (2026","cbCail20FBB03NFV","https://ap.wps.com/l/cbCail20FBB03NFV","pdf",4150774,"English","# Introduction\n# Case report\n# Discussion","[{\"question\":\"How was the patient’s papillary thyroid cancer initially managed after diagnosis?\",\"answer\":\"She underwent total thyroidectomy and received radioactive iodine (150 mCi) in 1997. Subsequent imaging and thyroglobulin monitoring were used to follow disease status.\"},{\"question\":\"Why was bronchoscopy performed in the operating room?\",\"answer\":\"A diagnostic bronchoscopy attempt was not tolerated, and the multidisciplinary team later decided on bronchoscopy in the operating room due to high risk.\"},{\"question\":\"What intervention was used to treat the endobronchial lesions?\",\"answer\":\"Aragon plasma coagulation was applied to both endobronchial lesions during bronchoscopy, aiming to control the endobronchial metastatic disease.\"}]","Papillary Thyroid cancer with endobronchial metastasis managed with Aragon plasma coagulation - A case report | PDF",1790588979,13]