Case Of Carcinoid Research Articles

Outcomes after surgical resection of pulmonary carcinoid tumors.

BackgroundPulmonary carcinoid tumors make up approximately one percent of all pulmonary tumors, and controversy exists regarding management and prognosis. We undertook a retrospective analysis of all patients who underwent surgical resection of pulmonary carcinoid tumors at our institution.MethodsFrom 1992 through 2014, 121 patients who underwent surgical resection of pulmonary carcinoid tumors were retrospectively reviewed. Patient demographics, pathologic data and long-term outcomes were recorded.ResultsThere were 96 patients with typical carcinoid tumors and 25 patients with atypical carcinoid tumors. All patients received complete resection of their tumors, with 90 % (109/121) of patients undergoing anatomic resection. There were no peri-operative mortalities. Eighty-one percent (98/121) of patients were female. Mean age was 60.7 years. Five and ten year survival rates were 96 % and 88 % respectively for typical carcinoid tumors, as compared to 87 % and 69 % respectively for atypical carcinoid tumors. Tumor size was not associated with survival (p = 0.98). Nodal metastases were evident in 8 % (8/96) of typical carcinoid tumors and 28 % (7/25) percent of atypical carcinoid tumors. Among typical carcinoid cases, the presence of nodal metastases were not associated with overall survival (p = 0.55). Among atypical carcinoid cases, the presence of nodal metastases also was not associated with survival (p = 0.53). No patients received neoadjuvant or adjuvant chemoradiation treatment.ConclusionsExcellent long-term outcomes can be achieved following surgical resection of pulmonary carcinoid tumors. The presence of nodal metastases was not associated with overall survival. Tumor size was not associated with either recurrence rates or survival.

Carcinoid Tumour of Caecum: an Unusual Palpable Mass in the Right Iliac Fossa.

Carcinoid tumour represents 0.8-1.5% of malignant digestive tumours. Gastrointestinal (GI) carcinoids account for 95% of all the carcinoids, and caecal carcinoids account for 5% of all the carcinoids. These tumours are frequent in women (2-4:1) as reported by Spallitta and Termine (Minerva Chir 55:77-87, 2002). In order of frequency, they may occur in the appendix (35%), ileum (28%), rectum (13%) and bronchi. Incidence is less than 1% in the pancreas, gall bladder, liver, larynx, testes and ovaries. The colon and ileocaecal region are rare sites of origin for gastrointestinal carcinoids as reported by Soga (J Exp Clin Cancer Res 17:139-48, 1998). They remain asymptomatic for years and many a times are diagnosed endoscopically, intraoperatively or during autopsy, based on their histopathological findings. We present a rare case of caecal carcinoid.

A case of rectal carcinoid, 7 mm in diameter, with skip metastasis to the lateral lymph node.

The present case study presented a 59-year-old man with a 7 mm submucosal tumor in the lower rectum and swelling in a 7 mm lateral lymph node (the obturator lymph node). No swelling of the lymph nodes within the mesorectum was observed. The patient underwent laparoscopic intersphincteric resection with left side lateral lymphadenectomy. At the pathological examination, the patient was diagnosed with a rectal neuroendocrine tumor (Grade 1; carcinoid), which had invaded the perirectal tissues and exhibited lateral lymph node metastasis; however, mesorectal lymph node metastasis was not observed, therefore, the definitive diagnosis was rectal carcinoid with skip metastasis to the lateral lymph node. No sign of recurrence was observed at the 3 year follow-up. The treatment algorithm of rectal carcinoid was decided by the risk of lymph node metastasis. The present study confirmed skip metastasis to the lateral lymph node from the rectal carcinoid, which is typically very slow growing and has a low grade malignant potential.

回腸カルチノイドの4例

本邦では非常に稀である回腸カルチノイドを，過去10年間で4例経験したため報告する．平均年齢55歳（52-57歳），男:2例・女:2例，主訴は便潜血陽性2例・腹痛2例であった．内視鏡所見として，回腸末端に黄色調の粘膜下腫瘍を認め，全例に生検を施行し，術前にカルチノイドの確定診断に至った．CT検査では，2例に所属リンパ節腫大が指摘されたが，遠隔転移は認めず，根治切除が可能と判断し，全例に腹腔鏡下回盲部切除術（D3郭清）を施行した．病理診断は，平均腫瘍径20mm（12-30mm），深達度は固有筋層，全例に近傍の所属リンパ節転移を認め，pT2N1M0，pStage IIIBであった．補助療法は施行せず，4例とも無再発生存中である．

術中胸水細胞診で診断に苦慮した胸腺原発非定型的カルチノイドの 1 例

術中胸水細胞診で診断に苦慮した胸腺原発非定型的カルチノイドの 1 例

Video-assisted thoracoscopic anatomic lung resection: experience of 246 operations

To present one of the largest materials of video-assisted thoracoscopic (VATS) anatomic lung resections in Russia. It is a retrospective analysis of treatment of 246 patients who underwent VATS anatomic lung resection for the period from 2010 to 2014 at the Center for Thoracic Surgery of St. Petersburg Clinical Hospital №122. One surgical team has operated 125 men and 121 women aged from 20 to 85 years (58.8±13.4 years). There were 216 (87.8%) lobectomies, 4 (1.6%) bilobectomies, 9 (3.7%) pneumonectomies, 10 (4.1%) segmentectomies and 7 (2.8%) trisegmentectomies. Upper right-side lobectomy was the most frequent in this group (87 (40.3%)). Most of operations was performed via 2 approaches (119 patients). Average length of the longest incision was 4.3±0.93 cm (range 2-6 cm). All patients were examined according to a single plan. FEV1 less than 70% was observed in 26% of patients; comorbidity index was 5 scores or more in 24% of cases; 23.2% of patients were older than 70 years. Non-small cell lung cancer (NSCLC) was diagnosed in 168 patients (68.3%), pulmonary tuberculosis - in 27 (11%), chronic suppurative lung disease - in 27 (11%) cases. Furthermore there were 9 cases of pulmonary metastases, 11 cases of carcinoid, 1 - MALT-lymphoma, 1 - leiomyoma, 2 - small cell lung cancer, as well as one case of IgG-associated pseudotumor. Among 168 cases of NSCLC operations were performed in 87 (51.8%) cases for cancer stage I, in 46 (27.3%) patients for stage II, in 27 patients for stage III (including 16 cases of stage IIIA and 11 cases of stage IIIB). 8 patients (4.7%) with lung cancer stage IV have been operated in radical surgery for solitary metastasis. Mean duration of surgery was 202.1±58.2 minutes (range 100-380). On the average 12.8±5.6 (range 9-32) mediastinal lymph nodes were excised during lymph node dissection in cancer patients. Mean number of nodes groups was 4.1±1.1. In 11 (4.5%) patients conversion to open surgery was made due to intraoperative bleeding (3 cases) and technical difficulties (8 cases). Mean duration of postoperative pleural drainage and hospital-stay were 5.1±4.3 (median - 3 days) and 7.9±4.7 days (median - 6 days) respectively. Complications which were not associated with perioperative deaths were observed in 66 patients (26.8%). Prolonged air vent was the most common complication. VATS anatomical lung resections are safe and effective in most of pulmonary surgical diseases. Such interventions may be recommended for wider introduction at the Thoracic Departments of Russia because of small number of complications and rapid rehabilitation. Bleeding or its risk associated with fibrotic changes in pulmonary root are the most frequent causes of conversion to open access.

Anaplastic Metastasis of Left-Sided Cardiac Carcinoid with Rapid Tricuspid Valve Involvement after Valve Replacement

Carcinoid tumors are rare and slow-growing neuroendocrine tumors. In the United States, the prevalence is reported at 2 cases per 100,000 persons. The classic carcinoid syndrome occurs in up to 5% of cases and its vasoactive effects can induce flushing, secretory diarrhea, bronchospasm and hypotension1. Carcinoid induced cardiac dysfunction is rare and involves development of plaques on the tricuspid and pulmonic valves, often manifesting as tricuspid insufficiency and pulmonic stenosis (TIPS). More specifically, these plaques cause hemodynamic dysfunction as a result of thickening and restricted motion of the valve leaflets. Of all cardiac carcinoid cases, the left-heart valves are affected in less than 10% of cases, due to atrial right-to-left shunt or primary bronchial carcinoid. Despite appropriate valve replacement therapy, rarely does the subsequent congestive heart failure resolve; necessitating an ongoing balance between cardiac treatment options and chemotherapy. Herein, we present a case of aggressive carcinoid heart disease manifesting as left-sided valvular plaque with subsequent development of severe tricuspid valve regurgitation after triple-valve replacement surgery. We will also review the treatment strategy in this patient with aggressive carcinoid syndrome.

Pathology of Struma Ovarii: A Report of 96 Cases.

Thyroid tissue is a relatively frequent component of mature teratoma and can occur in 5-20 % of cases. Struma ovarii is defined as ovarian goiter which comprises either entirely or predominantly thyroid tissue (>50 %). This also includes cases of mature teratoma with less than 50 % thyroid tissue but harboring thyroid-associated malignancy. A total of 118 patients with mature teratoma containing thyroid tissue were identified at our institution (1989 to 2014). Ninety-six cases were diagnosed struma ovarii, including 10 cases of papillary thyroid carcinoma, 1 case of highly differentiated follicular carcinoma of ovarian origin (HDFCO), 5 cases of strumal carcinoid, and 80 cases of struma ovarii (53 cases of thyroid-only struma ovarii). Six cases had diffuse adenomatous hyperplasia, and seven cases had focal adenomatous hyperplasia. There was no recurrence on follow-up except one of the papillary thyroid carcinomas. Concurrent primary ovarian lesions included: serous cystadenoma--3, mucinous cystadenoma--4, Brenner tumor--3, thecoma--2, ovarian fibroma--1, and focal hilus cell hyperplasia--4 cases. In this series, papillary thyroid carcinoma and strumal carcinoid were the most common well-differentiated neoplasm/malignancies arising in struma ovarii; these demonstrate a minimal or no aggressive clinical behavior.

Tumeurs neuroendocrines primitives du sein : étude rétrospective de 21 cas et revue de la littérature

PurposeThe aim of the present study was to discuss the epidemiology, clinical and pathologic features, treatment, and prognosis of primary neuroendocrine carcinomas of the breast. Patients and methodsWe report 21 cases diagnosed over a period of 12 years (1995–2011) at the university hospital of Sfax. A review of the clinical data with pathology and immunohistochemistry study was carried out for all the cases. ResultsThe average age was 62 years (34–86 years). At the time of the diagnosis, tumours were classified T1 and T2 (16 cases), N1 (11 cases) and M1 in two cases. The histological examination has shown 13 cases of solid neuroendocrine carcinoma, six cases of large cell type and two cases of atypical carcinoid. Grade I and II SBR were found in 18 cases. Eighty-one percent of the tumours were reactive for synaptophysin; all tumours were positive for chromogranin. Thirteen (61.9%) tumours were estrogen receptor-positive and 12 (57.5%) progesterone receptor-positive. Nineteen (90.5%) tumours were negative for HER2/neu. Overall five-year survival was 72.7%. All patients had surgical treatment with modified radical mastectomy in 13 cases. Adjuvant treatment was indicated according to histopronostic elements. ConclusionFor primary neuroendocrine carcinoma of the breast, multivariate analysis identified three predictive factors for mortality: disease stage, histological grade and lymph node involvement.

Bronchial neuroendocrine neoplasms: A Surveillance Epidemiology and End Results (SEER) database review of demographics and survival in 187,991 cases.

4097 Background: Bronchial neuroendocrine neoplasms (NENs) are a biologically heterogeneous group of malignancies whose differences are incompletely understood. We aimed to study the demographics and survival of patients with these neoplasms by reviewing the SEER database. Methods: We identified 945,331 cases in the SEER database with malignancies of the lung and extracted 187,991 bronchial NENs to examine patient characteristics & clinical outcomes by histology and stage. Results: By histology and grade, there were 130,092 cases of small cell carcinoma, 44,520 cases of large cell carcinoma, 3,349 cases of neuroendocrine carcinoma (grade 3/4), 9,135 cases of typical bronchial carcinoid (grade 1), and 895 cases of atypical bronchial carcinoid (grade 2). The ethnic predilection was Caucasian (87%, with 9% black and 4% other). Overall there were more cases in men (55% of the entire cohort), but women accounted for 66% of the carcinoid cases. Mean age at diagnosis for all NENs was 66, with typical carcinoids ...

E‐Posters

Carcinoid tumours are rare slow growing tumours which arise from primitive neuroendocrine cells. The effect of the pregnant state on carcinoid tumours and vice versa remains unclear, as does the optimal management of carcinoid tumours during the pregnancy including labour. We report the rare case of a 36 year old primigravida woman with large bilateral pulmonary carcinoid tumours. The patient's disease was minimally symptomatic with no clinical suspicion of carcinoid syndrome. Under close observation, the pregnancy progressed well and the patient proceeded to a spontaneous vaginal delivery of a healthy child. We conduct the the first literature review in 30 years of all reported cases in this area and make suggestions as to assessment and monitoring of cases of carcinoid during pregnancy.

術後6年で胸膜・腹膜播種を来した胸腺非定型カルチノイドの1例

術後6年で胸膜・腹膜播種を来した胸腺非定型カルチノイドの1例

A case of multicentric carcinoid in a patient with psoriatic spondyloarthropathy.

We describe the first case of a patient presenting with multicentric carcinoid occurring in the lung and subsequently in the rectum, with chronic psoriatic arthritis. Although reports have been published regarding carcinoid syndrome occurring alongside rheumatoid arthritis, no reports have been made on such a case. Initial presentation of carcinoid syndrome in this patient was insidious and atypical with few symptoms, including shortness of breath and long standing abdominal bloating. Several years later a sudden change in bowel habit prompted a colonoscopy with biopsy that revealed a carcinoid rectal polyp. The case we report describes a rare presentation of carcinoid syndrome in chronic psoriatic arthropathy.

Small Bowel Carcinoids: A Single Surgeon's Experience in Southern India.

Small bowel carcinoid tumours are indolent neuroendocrine tumours usually seen in the 6(th) and 7(th) decades. Most often, they are silent with non-specific symptoms. They generate serotonin, provoking a desmoplastic reaction in the mesentery leading to bowel ischemia and obstruction. While CECT abdomen can help raise suspicion and show regional spread, elevated 24-hour urinary 5-HIAA levels, histopathology and immunohistochemistry for Chromogranin A are confirmatory. To analyse a single surgeon's experience of clinical features and diagnosis of carcinoid tumours of the small intestine. Retrospective study conducted at MS Ramaiah Medical College and Hospital, Bangalore, India. Fourteen cases of carcinoid of the small bowel presenting to our institution over a 9-year period between December 2005 and November 2014 comprised the study. This included 10 males to 4 females aged 43 to 67 years (Mean: 54.4 years). The patients were investigated using x-ray abdomen, barium study, CECT abdomen, colonoscopy and 24-hour urinary 5- HIAA levels. All patients were surgically treated and histological examination of the resected tumours and immunohistochemistry for Chromogranin A was performed. Twelve patients with ileal carcinoids presented with long standing intestinal colic and sub-acute obstruction. Two patients with jejunal carcinoids had epigastric pain. X-ray abdomen was suggestive of small bowel obstruction in 12 patients. CECT abdomen done in 6 patients, showed ileal narrowing causing proximal dilatation; and cocooining of ileal loops at ileo-caecal junction in 2 cases. Ten patients underwent segmental resection-anastomosis of the tumour-bearing intestine while 4 patients underwent a right hemicolectomy. Lymph node spread was seen in 8 patients of whom 4 had liver metastases. Histopathology and Chromogranin A positivity confirmed the diagnoses. Postoperatively, 24-hour urinary 5-HIAA was mildly elevated in 2 patients. 12 patients were disease free at mean follow up of 4.3 years. 2 patients died due to inanition at 3 and 5 months postoperatively. Carcinoid tumours of small intestine are uncommon in southern India. But they should be considered as differential diagnosis when intestinal tuberculosis is suspected in the elderly presenting with intestinal colic or sub-acute obstruction. They are associated with good prognosis after adequate resection.

The Oncofetal Protein IMP3: A Useful Marker to Predict Poor Clinical Outcome in Neuroendocrine Tumors of the Lung

We evaluated the expression of the oncofetal protein IMP3 in a series of neuroendocrine tumors of the lung, correlating our results with proliferating index Ki67 and with the expression of the two most studied stem cell markers in lung cancer, Nanog and Oct3/4. A total of 74 patients with a diagnosis of neuroendocrine tumor including 46 cases of typical carcinoid, nine cases of atypical carcinoids, 13 cases of large cell neuroendocrine carcinomas and six cases of small cell carcinomas were enrolled. IMP3 was expressed in 50% of small cell carcinomas, 84% of large cell neuroendocrine carcinomas, 55% of atypical carcinoids and 10% of typical carcinoids. IMP3-positive cases showed significantly decreased overall and disease-free survival time compared with IMP3-negative cases. Nanog was expressed in 50% of small cell carcinomas, 31% of large cell neuroendocrine carcinomas, 33% of atypical carcinoids and 15% of typical carcinoids, and 68% of IMP3-positive tumors were also enriched for Nanog expression. Conversely, Oct3/4 expression could not be detected in all the analyzed series. When combining Ki67 and IMP3 expression we demonstrated that all the cases with a Ki67 index higher than 4% were also IMP3-positive, and their simultaneous expression was a poor prognostic factor. IMP3 is a marker of poor outcome in lung neuroendocrine tumors; its correlation with Nanog expression suggest an implication of IMP3 in stem cell processes and its association with a Ki67 labeling index higher than 4% stratifies a subset of atypical carcinoids with a higher risk of recurrence and mortality.

Neuroendocrine carcinoma of the urinary bladder:clinicopathologic features analysis of 17 cases

To investigate the clinicopathological characteristics and the prognosis of bladder neuroendocrine carcinoma (NEC). Clinicopathological data from 17 NEC of the bladder cases were collected, and immunohistochemical staining was performed with follow-up analysis and literature review. The recruited included 13 male and 4 female patients, aged from 48 to 86 years old (average 61 years; 14 patients >60 years). Gross hematuria of the whole urination course or intermittent was the initial symptom. Macroscopically, the outer surface of the tumor presented with polypoid, lobulated, fungating or ulcerous structures. Histologically, according to the criteria of WHO classification of neuroendocrine tumor of the lung, our NEC cases were divided into three histological types: 13 cases of small cell carcinoma, 3 cases of large cell neuroendocrine carcinoma and 1 case of atypical carcinoid. The urothelial carcinoma was concurrent with NEC in 6 cases, and adenocarcinoma was concurrent with NEC in 2 cases. Most tumor tissue infiltrated to the muscular layer, some infiltrated to the outer membrane. Immunohistochemically, the positive expression rates of CD56, Syn and CgA were 16/17, 16/17 and 12/17, respectively. The epithelial markers, including CK7 and CKpan, were also expressed with positive rates of 12/17 and 15/17, respectively. TTF-1 was positively expressed in 11 cases. The follow-up data were available in 14 cases, of which 9 patients died of the tumor 1-34 months after surgery (average, 11 months). Five patients lived uneventfully for 1-12 months after surgery. NEC is a rare malignant tumor of the bladder. Immunohistochemical markers such as CD56, Syn, CgA and CKpan could be helpful in determining the diagnosis and differential diagnosis of the tumor. NEC is a highly invasive malignant tumor with poor prognosis. Based on its biological behavior, radical cystectomy is the preferred method of treatment for the tumor.

Synchronous Small Intestinal Tumors: Discrete Duodenal Carcinoid and Adenocarcinoma

Introduction: A 49-year-old white female with diabetes mellitus type 2, coronary artery disease, myotonic muscular dystrophy, morbid obesity, and obstructive sleep apnea underwent evaluation for chronic fatigue, intermittent vomiting, diarrhea, and iron deficiency anemia. Endoscopy revealed nodular, congested duodenal bulb mucosa and a circumferential, protruding partially obstructing mass in the third portion of the duodenum (D3). Colonoscopy was unremarkable. Celiac serologies were negative and duodenal biopsies were without evidence of sprue. Duodenal bulb pathology revealed a low-grade neuroendocrine neoplasm with positive immunostain for synaptophysin, supporting a diagnosis of carcinoid. D3 mass pathology revealed a well-differentiated adenocarcinoma. She was deemed a poor surgical candidate due to extensive cardiac, pulmonary, and dystrophic muscular co-morbidities. After shared decision making, she was referred for palliative chemotherapy and radiation. Risk factors for small bowel adenocarcinoma include male gender, age greater 60, smoking, Crohn’s disease, celiac disease, and personal/family history of colon cancer. Carcinoid tumors are seen in multiple endocrine neoplasia, neurofibromatosis, and more frequently in African Americans than Caucasians. Myotonic dystrophy may explain the early onset of disease and absence of traditional disease risk factors. Myotonic dystrophy is an inherited, autosomal dominant group of diseases, resulting from repeat, unstable nucleotide expansions that can demonstrate genetic anticipation. This inheritance pattern and presence of genetic disorder may explain the early onset and concurrence of these 2 rare small bowel tumors. Composite tumors with areas of adenocarcinoma and carcinoid in the same tumor have been reported in the stomach, duodenum, ampulla, liver, appendix, colon, and rectum. A collision-type tumor involves adjacent, but separate components of carcinoid tumor and adenocarcinoma. We report the first case of separate small bowel carcinoid and adenocarcinoma in a young myotonic dystrophy patient.Figure 1

Interobserver Variability for the WHO Classification of Pulmonary Carcinoids

Pulmonary carcinoids are neuroendocrine tumors histopathologically subclassified into typical (TC; no necrosis, <2 mitoses per 2 mm) and atypical (AC; necrosis or 2 to 10 mitoses per 2 mm). The reproducibility of lung carcinoid classification, however, has not been extensively studied and may be hampered by the presence of pyknotic apoptosis mimicking mitotic figures. Furthermore, prediction of prognosis based on histopathology varies, especially for ACs. We examined the presence of interobserver variation between 5 experienced pulmonary pathologists who reviewed 123 originally diagnosed pulmonary carcinoid cases. The tumors were subsequently redistributed over 3 groups: unanimously classified cases, consensus cases (4/5 pathologists rendered identical diagnosis), and disagreement cases (divergent diagnosis by ≥2 assessors). κ-values were calculated, and results were correlated with clinical follow-up and molecular data. When focusing on the 114/123 cases unanimously classified as pulmonary carcinoids, the interobserver agreement was only fair (κ=0.32). Of these 114 cases, 55% were unanimously classified, 25% reached consensus classification, and for 19% there was no consensus. ACs were significantly more often in the latter category (P=0.00038). The designation of TCs and ACs by ≥3 assessors was not associated with prognosis (P=0.11). However, when disagreement cases were allocated on the basis of Ki-67 proliferative index (<5%; ≥5%) or nuclear orthopedia homeobox immunostaining (+; -), correlation with prognosis improved significantly (P=0.00040 and 0.0024, respectively). In conclusion, there is a considerable interobserver variation in the histopathologic classification of lung carcinoids, in particular concerning ACs. Additional immunomarkers such as Ki-67 or orthopedia homeobox may improve classification and prediction of prognosis.

An unusual case of thymic carcinoid causing Cushing's syndrome due to ectopic ACTH secretion detected by 18F-FDG PET/CT

Women newly diagnosed with breast cancer experience psychological distress, accompanied by reduced Natural Killer Cell Activity (NKCA) and altered levels of cytokines, which may compromise cancer control. Few studies have evaluated psycho-immune outcomes of mindfulness-based stress reduction (MBSR) for women newly diagnosed with breast cancer in comparison to an active control condition.The purpose of this study was to determine whether MBSR benefits psychological, behavioral, and immunological function in women recently diagnosed with breast cancer.After confirmation of breast cancer staging, women diagnosed with early-stage breast cancer (n = 192) were randomized to an 8-week MBSR program or an 8-week active control condition (ACC). The ACC consisted of a series of cancer recovery and health education classes. Both MBSR and the ACC were administered in group format.Women completed psychometric instruments and provided blood for NKCA and cytokine levels at pre-, mid-, and completion of program, as well as at 1- and 6-months post-program. One hundred and twenty four women completed all five-assessments (MBSR, n = 63; ACC, n = 61). Hierarchical linear modeling was used to analyze trajectories of outcomes over time and between groups.Compared to the ACC group, women randomized to MBSR exhibited decreasing trajectories of perceived stress, fatigue, sleep disturbance, and depressive symptoms. Further, compared to women randomized to ACC, MBSR women exhibited trajectories demonstrating significantly more rapid restoration of NKCA, accompanied by lower circulating TNF-alpha levels, lower IL-6 production, and greater IFN-gamma production.These results demonstrate early provision of MBSR for women newly diagnosed with breast cancer provides not only psychological benefit, but also optimizes immune function supportive of cancer control.

Bronchoscopic debulking followed by bronchoplastic procedure helps in limiting lung resection in a bronchial carcinoid: a case report.

Bronchoplasty is a conservative procedure in lung surgeries used in the past for patients with poor functional status but recently these procedures have been performed in low grade malignant tumors of lung avoiding extensive morbid procedure like pneumonectomy without compromising the oncologic outcome. We describe a case of bronchial carcinoid treated by bronchoscopic intervention followed by wedge bronchoplasty. The importance of bronchoscopic debulking of the tumor for accurate assessment of its extent has been highlighted. A parenchyma preserving pulmonary resection can then be performed with bronchoplastic technique, thus avoiding pneumonectomy.