It is Time for Endobronchial Therapy to Replace Surgery in the Treatment of Typical Bronchial Carcinoid (original) (raw)
Related papers
Medicine, 2016
Hamartomas are very rarely identified as an endobronchial lesion. Herein, we describe a peculiar case of a 55-year-old woman with persistent cough and increasing dyspnea and radiological detection of a solid lesion subtotally occluding the main right bronchus. Despite the radiological and radiometabolic (18-fluoro-2-deoxy-d-glucose positron emission tomography/computer tomography scan) features were highly suspected for bronchial carcinoid, the definitive diagnosis after endoscopic removal was indicative of an endobronchial hamartoma. When considering differential diagnosis of an endobronchial lesion, the physicians should take firmly in mind such rare entity and, accordingly, bronchoscopy and bronchoscopic biopsy should be done as first step in management of all cases presenting with endobronchial lesions.
An Unusual Finding of Tumorlet Carcinoid and Endobronchial Hamartoma in the Lobar Bronchus
International Journal of Morphology, 2022
Neuroendocrine lung tumours are a group of different tumours that have similar morphological, immunohistochemical and molecular characteristics, and represents 1-2 % of all malignant lung tumours. Tumorlet carcinoids represent the nodular proliferation of hyperplastic neuroendocrine cells that is smaller than 5 mm in size. In this study, we reported the unusual finding of tumour carcinoid and endobronchial hamartoma in the same bronchus. A 49-year-old male patient with symptoms of prolonged severe cough and fever, and was treated for pneumonia. Since he did not adequately respond to antibiotic therapy lung CT scan was performed which showed middle lobe bronchus obstruction. Bronchoscopy revealed a lobulated whitish tumour which was biopsied and histopathological diagnosis was hamartoma. Tumour could not be completely removed during bronchoscopy, it was decided to surgically remove it. On serial section, during gross examination in the same bronchus, an oval yellowish area with a diameter of 3 mm was found along the bronchial wall. According to gross and histomorphological characteristics and immunophenotype of tumour cells, the diagnosis of tumour carcinoid was set. Diagnosis of carcinoids of the tumorlet type is usually an accidental finding and it can be seen on CT in the form of subcentimeter, single or multiple, nodular changes. Considering that the clinical picture is nonspecific, they should always be kept in mind as a possible differential diagnosis.
Endobronchial Management of an Endobronchial Hamartoma
Turkiye Klinikleri Journal of Case Reports, 2019
enign lung tumors are rare tumors; consist of less than 1% of body tumors. Among these, hamartomas are the most common and found in the range of 0.02% to 0.3% incidence. 1 Hamartoma may locate into pulmonary parenchyma; these hamartomas are generally asymptomatic. Some hamartomas may be located in the trachea or bronchi, and present with result of tracheal or bronchial obstruction as cough, expectoration, and dyspnea. 2 Endobronchial hamartomas (EH) often grow and obstruct the bronchial lumen substantially without symptoms such as dyspnea, and wheezing. Without an apparent radiologic sign, the symptoms secondary to bronchial obstruction may lead to misdiagnosis of asthma. 1 Because of the benign nature of these tumors, bronchoscopic removal is generally recommended, but in patients with irreversible lung destruction surgical treatment should be performed. 3 We herein report a case of a bulky EH placed in the left main bronchus, diagnosed by bronchoscopy and extracted by endobronchial treatment via rigid bronchoscope. CASE REPORT A 52-year-old female patient with a 5-year history of asthma was admitted to the hospital complaining of chest pain and progressive shortness of breath. The patient was a nonsmoker and had no other significant medical his
Tüberküloz ve toraks, 2007
Endobronchial hamartoma is a rare tumor which is 3-10% of all hamartomas. We presented a case of endobronchial hamartoma that was resected and ablated with electrocautery and cryotherapy by fiberoptic bronchoscopy. A 71-year-old male, presented with progressive dyspnea on exertion, chest pain and hemoptysis. Chest computed tomography (CT) scan of the patient revealed a mass lesion mostly obliterating tracheal lumen and left main bronchus. An initial bronchoscopy showed a large polypoid lesion within the left mainstem bronchus. Polypoid lesion protrudes to the right with respiration. Interventional bronchoscopy with snare probe of the electrocautery resected the polyp in 4 pieces followed by cryotherapy of the base. Pathology of the resected lesion diagnosed as bronchial hamartoma with fibrovascular component. Control bronchoscopy applied 10 days later revealed patency of all airways. The majority of hamartomas is parenchymal and is often located in the periphery of the lung, unlike ...
Endobronchial Treatments of Carcinoid Tumors of the Lung
2015
Background Bronchial carcinoid tumors are known as low-grade malignancies. Surgery has been proposed as the best treatment of choice for lung carcinoids. However, less invasive treatment approaches may be considered due to low-grade malignancy potential of such tumors. The aim of this study was to review the results of endobronchial treatments of carcinoid tumors of the lung and to compare with the outcome after surgery. Methods Initial complete tumor eradication with an endobronchial treatment was attempted for 29 patients. Diode laser or argon plasma coagulation was used during these treatments. Cryotherapy or laser treatments were applied consecutively in patients for whom there was good bronchoscopic visualization of the distal and basal tumor margins and no evidence of bronchial wall involvement. Surgery was performed in cases of atypical carcinoid and in cases of nonvisualization of the basal and distal part of the tumor. Results Overall, 29 patients have been included (median age 58 years; range, 23-77 years). Median follow-up has been 49 months (range, 22-94 months). A total of 24 patients (69%) had typical carcinoid tumor, 5 patients (31%) had atypical carcinoid tumor. Initial endobronchial treatment provided complete tumor eradication in 21 of 29 patients (72%). Of the eight other patients (28%), two were atypical carcinoids, and underwent surgical treatment. There was no tumor-related death and no recurrence during the follow-up in both groups. There was no difference for survival or recurrence between the surgical and the endobronchial treatment group of patients (p > 0.05). Conclusion Endobronchial treatment may be considered as safe, effective treatment for typical carcinoid tumors in the central airways. Addition of initial endobronchial treatment had no negative effect on the surgical outcome.
Endobronchial Treatment of Carcinoid Tumors of the Lung
The Thoracic and cardiovascular surgeon, 2015
Background Bronchial carcinoid tumors are known as low-grade malignancies. Surgery has been proposed as the best treatment of choice for lung carcinoids. However, less invasive treatment approaches may be considered due to low-grade malignancy potential of such tumors. The aim of this study was to review the results of endobronchial treatments of carcinoid tumors of the lung and to compare with the outcome after surgery. Methods Initial complete tumor eradication with an endobronchial treatment was attempted for 29 patients. Diode laser or argon plasma coagulation was used during these treatments. Cryotherapy or laser treatments were applied consecutively in patients for whom there was good bronchoscopic visualization of the distal and basal tumor margins and no evidence of bronchial wall involvement. Surgery was performed in cases of atypical carcinoid and in cases of nonvisualization of the basal and distal part of the tumor. Results Overall, 29 patients have been included (median...
Bronchoscopic management of endobronchial carcinoid presenting as asthma Mimic
Respiratory Medicine Case Reports, 2020
We report a 25-year-old woman with persistent dyspnea and wheezes that had been unsuccessfully treated with inhaled beta 2-agonists and steroids for about one year. Spirometry demonstrated a restrictive pattern. Chest CT demonstrated polypoidal lesion in left main bronchus. The lesion was excised via rigid bronchoscopy. Pathology showed a picture of typical bronchial carcinoid. In this patient, due to the lack of awareness, diagnosis of carcinoid was delayed for one year.
Bronchoscopic management of a rare benign endobronchial tumor
Revista portuguesa de pneumologia
Benign endobronchial tumors are uncommon. Bronchoscopic removal is the preferred modality of treatment although surgery may be required in some cases. Rigid bronchoscopy is usually recommended in the management of these tumors. However, flexible bronchoscopy is also used in many centers. We present a case of endobronchial lipoma, where an unusual complication during flexible bronchoscopic resection using snare forceps necessitated urgent rigid bronchoscopy. This case highlights the importance of rigid bronchoscopy in the management of endobronchial tumors. We believe that with a large benign endobronchial tumor in tracheal or main-stem bronchus, physicians should initially employ rigid bronchoscopy, switching to flexible if more peripheral treatment is required.
Endobronchial carcinoid managed by surgery and radiation therapy
European Journal of Radiology Extra, 2006
Carcinoid tumor is a rare entity accounting for less than 2% of bronchial neoplasms. The clinical presentation is highly variable and rarely, it may present as a solitary pulmonary nodule. Management is by surgical removal. Role of radiation is unclear.
Proceedings of Singapore Healthcare, 2021
We present a 70-year-old gentleman with chronic cough with haemoptysis found to have left lower zone collapse on imaging. The bronchoscopy showed an endobronchial mass histologically of a non-secreting atypical carcinoid. Poor baseline lung function excluded surgical resection, and instead, he successfully underwent a bronchoscopic debulking procedure which improved his FEV1 to 84% and DLCO 83% predicted. Unfortunately, the tumour regrew, but the calculated percentage predicted postoperative for FEV1 (64%), and DLCO (65%) enabled definitive surgical resection to take place. Surgical resection remains the definite curative option for localised endobronchial atypical carcinoid tumours. Achieving this in proximal endobronchial carcinoid tumour is a challenge. We described an endoscopic tumour debulking procedure as a bridge for curative surgical resection in a patient with an inoperable proximal atypical carcinoid tumour due to poor predicted postoperative lung function. We highlighted...