Dr. Pham Thi Le Quyen, deputy head of the respiratory department at Tam Anh General Hospital Hanoi, stated that a brain tumor biopsy carried a risk of neurological complications due to the patient's widespread brain edema. Meanwhile, the lung tumor was situated deep in the lung hilum, close to major blood vessels, making trans-thoracic biopsy impossible.

A multidisciplinary team comprising respiratory, oncology, pathology, imaging, thoracic surgery, and neurology specialists convened a consultation and decided to perform endobronchial ultrasound (EBUS). This minimally invasive procedure allowed access to central lesions that were difficult to biopsy. Instead of open surgery or brain intervention to identify the tumor's origin, doctors could obtain tissue samples from the lung hilum tumor via EBUS, significantly reducing the risk of severe complications for the patient.

Doctor Quyen (center) performs an endobronchial ultrasound to biopsy a tumor in the lung hilum. Photo: Tam Anh General Hospital

Doctors used an ultrasound probe attached to a bronchoscope to visualize deep lesions around the airway, such as mediastinal tumors and those in the lung hilum. A needle was then guided through the bronchial wall to obtain precise tissue samples. This method allowed access to locations difficult to reach with trans-thoracic biopsy or conventional bronchoscopy. Pathology results confirmed Binh had pulmonary adenocarcinoma.

"Identifying the primary lesion guides treatment, from gene mutation testing and targeted therapy to immunotherapy and brain radiation," Dr. Quyen explained.

Currently, Binh is receiving active treatment with targeted drugs and radiation therapy for his brain tumor. His health is stable, and his prolonged headaches and dizziness have decreased.

Many early-stage lung cancer cases present with almost no respiratory symptoms, such as persistent cough, chest pain, or shortness of breath. Patients often discover the disease only when the tumor has grown large and metastasized to other organs, as in Binh's case. Doctors recommend regular health check-ups and low-dose CT lung screening for individuals with a history of smoking, exposure to toxic environments, those over 50, or those with a family history of lung cancer.

According to Dr. Quyen, endobronchial ultrasound is considered indicated when diagnostic tissue samples are needed for lesions located deep within, in the central region of the lung, or close to the airway. This method also aids in sampling mediastinal lymph nodes to stage lung cancer, thereby helping doctors select appropriate treatment methods.

Khue Lam