Bronchoscopic Management of Endobronchial Atypical Carcinoid With Argon Plasma Coagulation and Laser: A Rare Case With Literature Review

Andrew Talon,Ali Saeed,Melinda Wang

doi:10.7759/cureus.13862

Andrew Talon, Ali Saeed + Show 1 more

Open Access

https://doi.org/10.7759/cureus.13862

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Abstract

Atypical carcinoid belongs to a spectrum of neuroendocrine tumors that can present as central airway obstruction. We treated a 58-year-old female who presented with recurrent pneumonia. Flexible bronchoscopy showed complete obstruction of the tumor in the right lower lobe. The tumor was excised by electrocautery snare followed by laser and argon plasma coagulation (APC). Endobronchial biopsy showed atypical carcinoid with lymph node metastasis. Succeeding bronchoscopic management, the patient’s symptoms improved. In our patient, bronchoscopy with laser and APC was performed to prevent tumor recurrence after resection and reduce the risk of recurrent postobstructive pneumonia. Surveillance computed tomography at six months showed no evidence of recurrence. Bronchoscopic management should be considered in poor surgical candidates or patients with metastatic disease.

Highlights

Atypical carcinoid (AC) is a rare neuroendocrine tumor that can present as an obstructing endobronchial mass [1]
We present a case of endobronchial AC managed with bronchoscopy
ACs belong to a spectrum of neuroendocrine tumors that account for 2% of all primary lung tumors [1]

Summary

Introduction

Atypical carcinoid (AC) is a rare neuroendocrine tumor that can present as an obstructing endobronchial mass [1]. A 58-year-old female developed dyspnea and a productive cough She was diagnosed with pneumonia and received antibiotics. The patient’s cough and dyspnea were immediately improved. She was referred to oncology and was treated with carboplatinpaclitaxel chemotherapy with concurrent fractionated radiotherapy. How to cite this article Talon A, Wang M, Saeed A (March 12, 2021) Bronchoscopic Management of Endobronchial Atypical Carcinoid With Argon Plasma Coagulation and Laser: A Rare Case With Literature Review. VIDEO 1: Dr Ali Saeed, MD, Medical Director of Interventional Pulmonology (Norton Thoracic Institute, Phoenix, AZ) performing flexible bronchoscopy in a patient with an obstructing right lower lobe endobronchial mass and bronchocele. Tumor was excised with electrocautery snare and cryoprobe followed by diode laser and APC to prevent tumor recurrence

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Disclosures