Advanced age chest wall hamartoma and typical carcinoid tumor: a very rare coexistence

A retrospective study was conducted on 32 patients who had had bronchial carcinoid tumors between 1965 and 1989. The average age of the patients was 48.5 years, with a male to female ratio of 3.6:1. Of the 32 patients, 28 were diagnosed pathologically to have typical bronchial carcinoid tumors and the other four, atypical bronchial carcinoid tumors. Twenty-two of the 28 typical bronchial carcinoid tumors were classified as stage I, but only one of the four atypical bronchial carcinoid tumors was at stage I. Two typical carcinoid tumor patients and two atypical carcinoid tumor patients were found, pathologically, to have lymph node metastasis. The typical carcinoid tumors showed a more significant endobronchial polypoid growth than the atypical carcinoid tumors (P = 0.0138). The five-year-survival rate was 100% in patients with typical carcinoid tumors and 25% in those with atypical carcinoid tumors. The difference between the five-year-survival rate for the typical carcinoid and atypical carcinoid patients was statistically significant (P = 0.001).

Lung carcinoid tumors are malignant neuroendocrine neoplasms that account for less than 2% of all lung malignancies and include two histological types: typical and atypical carcinoid tumors. Typical carcinoid tumors do not include areas of necrosis and show less than 2 mitotic figures within 10 high grade fields. On the molecular level, carcinoid tumors present alterations in gene MEN1 as well as a high expression of genes ASCL1 and EIF1AX. We report a systems biology approach using BioNetUCR and Copasi in addition to Cytoscape to identify mi-RNA regulators of the most important altered genes in typical pulmonary carcinoid tumors. The final adjusted and reduced interaction network of our genes of interest included: 3 genes 12 transcription factors and 7 mi-RNAs, leading to a total of 22 nodes and 53 edges. Analysis with Copasi showed that MIR24-2 regulates the expression of MEN1 and MIR129-1 regulates the expression of AIF1AX. Those mi-RNAs could be potential targets for molecular therapy in patients with typical carcinoid tumor of lung.

Wedge Resection Offers Similar Survival to Segmentectomy for Typical Carcinoid Tumors

Trends in Prognostic Factors for Neuroendocrine Lung Tumors

Typical and atypical carcinoid tumors belong to the neuroendocrine lung tumors. They have low recurrence and proliferation rate, lymph node, and distant metastases. Nevertheless, these tumors have shown a more aggressive behavior. In the last years, microRNAs were screened as new tumor markers for their potential diagnostic and therapeutic relevance. The expression of hsa-let-7b-5p, hsa-let-7f-5p, hsa-miR-222-3p, and their targets HMGA2 (high-mobility group A2) and CDKN1B (cyclin-dependent kynase inhibitor 1B, p27kip1) was evaluated in this rare small group of patients. We analyzed the clinical data of all typical and atypical carcinoid tumors of patients who underwent surgical operation at Marburg University Hospital (n = 18) from 2000. Quantitative reverse transcription polymerase chain reaction was performed in formalin-fixed paraffin-embedded tumor tissue versus four tumor-free lung tissue samples. HMGA2 was stable or downregulated; only one patient showed a significant overexpression. CDKN1B showed a significant overexpression or a stable level; it was downregulated in two samples only. Hsa-miR-222-3p resulted almost stable or overexpressed except for two samples (significantly downregulated). Hsa-let-7f-5p was stable or overexpressed in the majority of analyzed samples, whereas hsa-let-7b-5p was significantly downregulated. HMGA2 and CDKN1B are differently expressed between atypical and typical carcinoid tumors, thus representing valid biomarkers for the classification of the two tumor groups. Hsa-let-7f-5p and HMGA2 are inversely correlated. Hsa-miR-222-3p does not correlate with its predicted target CDKN1B.

Typical and Atypical Pulmonary Carcinoids: Outcome in Patients Presenting With Regional Lymph Node Involvement

Rare Pleural Recurrence of Typical Pulmonary Carcinoid Tumor 30 Years After Lobectomy

Natural History of Typical Pulmonary Carcinoid Tumors: A Comparison of Non surgical and Surgical Treatment

Long-term outcome of bronchoscopically resected endobronchial typical carcinoid tumors

Surgical treatment was performed in 286 patients with lung cancer. The final morphological study diagnosed typical and atypical carcinoid tumors in 258 (90.2%) and 28 (9.8%) patients, respectively. The central and peripheral tumor sites were established in 245 (85.7%) and 41 (14.3%) patients, respectively. According to disease stage, the patients were distributed as follows: Stage I in 166 patients, Stage II in 84, Stage III in 30, and Stage IV in 6. Five (1.7%) patients were found to have carcinoid syndrome: the tumor had the morphological structure of atypical and typical carcinoid tumors in 3 and 2 patients, respectively. One patient with typical carcinoid was observed to have carcinoid syndrome concurrent with the Itsenko-Cushing syndrome. Two patients with carcinoid syndrome were ascertained to have hepatic metastases; these patients were recognized to be inoperable. The basic type of surgical intervention for typical carcinoid tumors was an organ-saving operation: lobectomy, bilobectomy, reconstructive plastic surgery, precision removal, and segmental resection. Only 7 patients underwent endoscopic removal of typical carcinoid tumors. In atypical carcinoid tumors, the surgical volume depends on the specific features of the extent of a tumor and the presence or absence of metastases. Pneumonectomy with lymphadenectomy and lobectomy in combination with and without bronchial resection were performed in half the cases. The long-term results of radical surgical treatment in patients with bronchopulmonary carcinoid tumors suggest that these operations are warranted.

Bilateral multiple typical carcinoid tumors of the lung are uncommon malignancies. We discuss the case of a 64 year-old female with a nonproductive cough as the initial symptom. Thoracic computed tomography revealed multiple nodular lesions on both sides, which were initially misdiagnosed as multiple metastases of the lung with an unknown primary. After resection of nodules in the right hemithorax, pathologic examination revealed a typical carcinoid tumor. Bilateral sequential thoracotomy was performed and all ten nodules, (six on the right side and four on the left side), were treated by sublobar resection due to poor respiratory function. Pathological examination revealed all nodules to be typical carcinoid tumors. Following the resections, the patient has remained disease-free for ten months.

Anatomic Pulmonary Resection is Associated With Improved Survival in Typical Carcinoid Lung Tumor Patients.

Carcinoid tumors of the lung: A report of 11 cases

The spectrum of primary neuroendocrine tumors of the lungs ranges from typical carcinoid tumors, which are relatively benign, to highly aggressive small-cell carcinoma. In this review, we summarize the treatment of bronchopulmonary carcinoid, a disease with an incidence of 0.5 per 100,000 persons per year in Western countries. We selectively searched the PubMed database for scientific evidence on the treatment of bronchopulmonary carcinoid, considering only articles published up to February 2015. We also performed a survival analysis of 84 patients with this disease who underwent interdisciplinary treatment at the University of Freiburg Medical Center. Carcinoid tumors account for less than 1% of all lung tumors. They manifest themselves clinically with cough (35%), hemoptysis (25%), and/or bronchial obstruction (40%), depending on their location, size, and pattern of growth. 30% of patients are asymptomatic, and less than 1% have hormone-associated symptoms. Typical and atypical carcinoid tumors are distinguished on a histological basis; the histologic differential diagnosis also includes large-cell neuroendocrine tumors and small-cell carcinoma of the lung. 80% of patients who undergo resection of typical carcinoid tumors survive at least 10 years. Atypical carcinoid tumors recur more commonly than typical ones. If the mediastinal lymph nodes are involved, adjuvant treatment should be considered. Because of their rarity, the treatment of bronchopulmonary carcinoid tumors presents an interdisciplinary challenge. Surgical resection, the treatment of choice for local carcinoid tumors, generally leads to long-term survival. The existing registers should be made more comprehensive so that the treatment of this disease can be better in the future.

Tumeurs carcinoïdes bronchopulmonaires : une série tunisienne de 115 cas opérés