Bronchial Carcinoid is an uncommon low grade neuroendocrine malignancy with metastatic potential which accounts for 2% of all lung cancers. Carcinoid usually occurs in adults, with an average age of 45-years. However, it is the most common primary lung neoplasm of children. Most patients in the latter group are adolescent. There is no documented association with cigarette smoking.

 

There are two pathologic types of endobronchial carcinoid: typical and atypical. Typical carcinoid (as in this particular case) is the more common type, is associated with the main, lobar, or segmental bronchi, tends to be small at presentation, and only 5% of patients have lymph node involvement when first seen. Atypical carcinoid makes up 10-20% of pulmonary carcinoid tumors and is larger at first presentation. These latter tumors are more likely to develop in the peripheral lung in the 8th decade of life or later. Lymph node involvement with atypical carcinoid is more common, seen in 50-60% cases. Carcinoid often metastasizes to the liver, bone, brain, and adrenals. The osseous metastases tend to be sclerotic.

 

 

Affected patients are usually symptomatic with cough and recurrent infections related to bronchial obstruction. Hemoptysis, dyspnea, wheezing, and chest pain have also been reported. Infrequently, affected patients may present with symptoms secondary to ectopic adrenocorticotropic hormone (ACTH) production such as fluid retention and increased urination.

 

 

 

Atypical carcinoid tumor: 69% 5-year survival; increased risk for local recurrence