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Category: Volume 06 Issue 10 October 2018
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Title: Endobronchial Carcinoid Tumours – A Case Series and review of Literature

Authors: Dr Rajesh V, Dr Melcy Cleetus, Dr Jolsana Augustine, Dr Divya R, Dr Sunitha Thomas, Dr Latha Abraham

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i10.64

Abstract

Bronchial carcinoid tumors are neuroendocrine neoplasms. The spectrum can range from low-grade typical carcinoids to more aggressive atypical carcinoids. Most bronchial carcinoids are located in central airways, hence clinical features and radiologic findings are usually related to bronchial obstruction. The aim of the present study was to describe the presenting clinical features, radiological findings, histological features, treatment modalities and outcome in pulmonary carcinoid tumours diagnosed in a tertiary care institute in Kerala, South India. This was a retrospective observational study of all cases of pulmonary carcinoids that presented to the Pulmonary Medicine department of our institute between August 2015 to July 2018. The clinical presentation, radiological features, stage of disease, histology, treatment instituted and survival was noted from the electronic medical case records.8 cases of lung carcinoid tumours were encountered during the study period. The mean age of study subjects was 50.6 years. Equal sex predilection was noted. Lower lobes were involved most frequently and right side was affected commoner than the left. Hemoptysis, recurrent respiratory infections and lobar / segmental collapse were the common clinical presentations. All patients had their diagnosis established by bronchoscopic biopsy. Carcinoid tumors accounted for 0.33 percent of pulmonary admissions in the present study. Most of the lesions were central. Symptoms of airway involvement dominated the clinical and radiological presentation. All except one case was subjected to surgical resection with no mortality noted during the study period and follow up.

Keywords: bronchial carcinoid, bronchoscopy, lung tumor, neuroendocrine tumor.

References

  1. Warren WH, Gould VE, Faber LP, Kittle CF, Memoli VA. Neuroendocrine neoplasms of the bronchopulmonary tract. A classification of the spectrum of carcinoid to small cell carcinoma and intervening variants. J Thorac Cardiovasc Surg. 1985 Jun;89(6):819–25.
  2. Bhatia K, Ellis S. Unusual lung tumours: an illustrated review of CT features suggestive of this diagnosis. Cancer Imaging. 2006 Jul 4;6(1):72–82.
  3. Hurt R, Bates M. Carcinoid tumours of the bronchus: a 33 year experience. Thorax. 1984 Aug 1;39(8):617–23.
  4. Han B, Sun J-M, Ahn JS, Park K, Ahn M-J. Clinical outcomes of atypical carcinoid tumors of the lung and thymus: 7-year experience of a rare malignancy at single institute. Med Oncol. 2013 Mar;30(1):479.
  5. Zhong CX, Yao F, Zhao H, Shi JX, Fan LM. Long-term outcomes of surgical treatment for pulmonary carcinoid tumors: 20 years’ experience with 131 patients. Chin Med J (Engl). 2012 Sep;125(17):3022–6.
  6. Cardillo G, Sera F, Di Martino M, Graziano P, Giunti R, Carbone L, et al. Bronchial carcinoid tumors: nodal status and long-term survival after resection. Ann Thorac Surg. 2004 May;77(5):1781–5.
  7. Lubarsh O. Uber den pimaeren krebs des ileum nebst Bemerkungen ueber das gleichzeitige Vorkommen von krebs und Tuberculos. Virchows Arch. 1888;(11): 280–317.
  8. Gosset A, Masson P. Tumeurs endocrines de l’appendice. Presse Med. 1914; (25):237–9.
  9. Hamperl H. Uber gutartige bronchialtu-moren (cylindrome und carcinoide). Virchows Arch. 1937;(300):46–88.
  10. Modlin IM, Sandor A. An analysis of 8305 cases of carcinoid tumors. Cancer. 1997 Feb 15;79(4):813–29.
  11. Newton JN, Swerdlow AJ, dos Santos Silva IM, Vessey MP, Grahame-Smith DG, Primatesta P, et al. The epidemiology of carcinoid tumours in England and Scotland. Br J Cancer. 1994 Nov;70(5):939–42.
  12. Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer. 2003 Feb 15;97(4):934–59.
  13. Fink G, Krelbaum T, Yellin A, Bendayan D, Saute M, Glazer M, et al. Pulmonary Carcinoid: Presentation, Diagnosis, and Outcome in 142 Cases in Israel and Review of 640 Cases From the Literature. CHEST. 2001 Jun 1;119(6):1647–51.
  14. Singh Ospina N, Thompson GB, C. Nichols F, D. Cassivi S, Young WF. Thymic and Bronchial Carcinoid Tumors in Multiple Endocrine Neoplasia Type 1: The Mayo Clinic Experience from 1977 to 2013. HORM CANC. 2015 Dec 1;6(5):247–53.
  15. Dusmet ME, McKneally MF. Pulmonary and thymic carcinoid tumors. World J Surg. 1996 Feb;20(2):189–95.
  16. Hasleton PS. Histopathology and prognostic factors in bronchial carcinoid tumours. Thorax. 1994 Sep;49 (Suppl):S56–62.
  17. Harpole DH, Feldman JM, Buchanan S, Young WG, Wolfe WG. Bronchial carcinoid tumors: A retrospective analysis of 126 patients. The Annals of Thoracic Surgery. 1992 Jul;54(1):50–5.
  18. McCaughan BC, Martini N, Bains MS. Bronchial carcinoids. Review of 124 cases. J Thorac Cardiovasc Surg. 1985 Jan;89(1):8–17.
  19. Ranchod M, Levine GD. Spindle-cell carcinoid tumors of the lung: a clinicopathologic study of 35 cases. Am J Surg Pathol. 1980 Aug;4(4):315–31.
  20. Okike N, Bernatz PE, Woolner LB. Carcinoid Tumors of the Lung. :8.
  21. Davila DG, Dunn WF, Tazelaar HD, Pairolero PC. Bronchial carcinoid tumors. Mayo Clin Proc. 1993 Aug;68(8):795–803.
  22. Caplin ME, Baudin E, Ferolla P, Filosso P, Garcia-Yuste M, Lim E, et al. Pulmonary neuroendocrine (carcinoid) tumors: European Neuroendocrine Tumor Society expert consensus and recommendations for best practice for typical and atypical pulmonary carcinoids. Ann Oncol. 2015 Aug;26(8):1604–20.
  23. Detterbeck FC. Management of carcinoid tumors. Ann Thorac Surg. 2010 Mar;89(3):998–1005.
  24. Filosso PL, Rena O, Donati G, Casadio C, Ruffini E, Papalia E, et al. Bronchial carcinoid tumors: surgical management and long-term outcome. J Thorac Cardiovasc Surg. 2002 Feb;123(2):303–9.
  25. Marty-Ané CH, Costes V, Pujol JL, Alauzen M, Baldet P, Mary H. Carcinoid tumors of the lung: do atypical features require aggressive management? Ann Thorac Surg. 1995 Jan;59(1):78–83.
  26. Travis WD, Rush W, Flieder DB, Falk R, Fleming MV, Gal AA, et al. Survival analysis of 200 pulmonary neuroendocrine tumors with clarification of criteria for atypical carcinoid and its separation from typical carcinoid. Am J Surg Pathol. 1998 Aug;22(8):934–44.
  27. Skov BG, Krasnik M, Lantuejoul S, Skov T, Brambilla E. Reclassification of neuroendocrine tumors improves the separation of carcinoids and the prediction of survival. J Thorac Oncol. 2008 Dec;3(12):1410–5.
  28. van Boxem TJ, Venmans BJ, van Mourik JC, Postmus PE, Sutedja TG. Bronchoscopic treatment of intraluminal typical carcinoid: a pilot study. J Thorac Cardiovasc Surg. 1998 Sep;116(3):402–6.
  29. Brokx HAP, Paul MA, Postmus PE, Sutedja TG. Long-term follow-up after first-line bronchoscopic therapy in patients with bronchial carcinoids. Thorax. 2015 May;70(5):468–72.
  30. Yao JC, Fazio N, Singh S, Buzzoni R, Carnaghi C, Wolin E, et al. Everolimus for the treatment of advanced, non-functional neuroendocrine tumours of the lung or gastrointestinal tract (RADIANT-4): a randomised, placebo-controlled, phase 3 study. Lancet. 2016 Mar 5;387(10022):968–77.
  31. Filosso PL, Guerrera F, Evangelista A, Welter S, Thomas P, Casado PM, et al. Prognostic model of survival for typical bronchial carcinoid tumours: analysis of 1109 patients on behalf of the European Association of Thoracic Surgeons (ESTS) Neuroendocrine Tumours Working Group. Eur J Cardiothorac Surg. 2015 Sep;48(3):441–7; discussion 447.
  32. Steuer CE, Behera M, Kim S, Chen Z, Saba NF, Pillai RN, et al. Atypical carcinoid tumor of the lung: a surveillance, epidemiology, and end results database analysis. J Thorac Oncol. 2015 Mar;10(3):479–85.

Corresponding Author

Dr Jolsana Augustine

Consultant Pulmonologist, Dept of Pulmonary Medicine, Rajagiri Hospital, Aluva, Kerala, 683112, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile number: 9446728953, 0484- 29055039