Talon Andrew, Wang Melinda, Saeed Ali
Internal Medicine, Creighton University School of Medicine, St. Joseph's Hospital and Medical Center, Phoenix, USA.
Interventional Pulmonology, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, USA.
Cureus. 2021 Mar 12;13(3):e13862. doi: 10.7759/cureus.13862.
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.
非典型类癌属于神经内分泌肿瘤谱系,可表现为中央气道阻塞。我们治疗了一名58岁的女性,她因反复肺炎就诊。柔性支气管镜检查显示右下叶肿瘤完全阻塞。通过电圈套器切除肿瘤,随后进行激光和氩等离子体凝固(APC)治疗。支气管内活检显示为伴有淋巴结转移的非典型类癌。经过后续的支气管镜管理,患者症状有所改善。在我们的患者中,进行激光和APC支气管镜检查是为了防止切除后肿瘤复发,并降低复发性阻塞性肺炎的风险。六个月后的监测计算机断层扫描显示无复发迹象。对于手术条件差或患有转移性疾病的患者,应考虑支气管镜管理。