Kosin Med J.  2017 Dec;32(2):221-226. 10.7180/kmj.2017.32.2.221.

A 14-year-old boy with endobronchial carcinoid tumor presenting with asthma

• Gu Y
• Hwang Y
• Kim S

• KMID: 2400265
• DOI: http://doi.org/10.7180/kmj.2017.32.2.221

Abstract

INTRODUCTION
Bronchial carcinoid tumors seldom occur in children, sometimes mistaken for a minor disease and diagnosed slowly.
MATERIALS AND METHODS
We report on a patient who diagnose tumors slowly because confused with asthma.
RESULTS
This case describes a 14-year-old boy, presenting with asthma-like symptoms throughout 3 years. He was treated as asthma but wax and wane. Chest x-ray showed an hyperlucent left lung, so we rechecked high resolution computed tomography (HRCT) for unilateral hyperinflation diseases diagnosis. It was found 1×1cm nodule in left main bronchus. We did bronchoscopy and discovered a round mass in the left bronchus, 2∼3cm away from carina. In the biopsy, it was bronchial carcinoid tumor, so we resected tumor. DISCUSSION: Because symptoms of bronchial carcinoid tumors are various, it can often be misdiagnosed firstly. It is confused with asthma, pneumonia and foreign body. An additional examination were necessary when respiratory symptoms persist.

Keyword

Bronchial; Carcinoid; Tumor

MeSH Terms

Adolescent*
Asthma*
Biopsy
Bronchi
Bronchoscopy
Carcinoid Tumor*
Child
Diagnosis
Foreign Bodies
Humans
Lung
Male*
Pneumonia
Thorax

Figure

• 

  Fig. 1. Spirometry shows obstructive lung disease with hypersensitivity of air way.

• 

  Fig. 2. Chest x-ray shows both lung hyperinflation with Left lung hyperlucent lung field.

• 

  Fig. 3. High resolution computed tomography (HRCT) shows an endobronchial nodule in Left main brohcus (1 x 1 cm).

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  Fig. 4. Bronchoscopy before surgery shows a tumor obstructed left main bronchus from carina.

• 

  Fig. 5. Bronchoscopy after surgery shows bronchus resected a tumor.

Reference

1.Lal DR., Clark I., Shalkow J., Downey RJ., Shorter NA., Klimstra DS, et al. Primary epithelial lung malignancies in the pediatric population. Pediatr Blood Cancer. 2005. 45:683–6.

2.Hauso O., Gustafsson BI., Kidd M., Waldum HL., Drozdov I., Chan AKC, et al. Neuroendocrine tumor epidemiology: contrasting Norway and North America. Cancer. 2008. 113:2655–64.

3.Wang LT., Wilkins EW Jr., Bode HH. Bronchial carcinoid tumors in pediatric patients. chest. 1993. 103:1426–8.

4.Eyssartier E., Ang P., Bonnemaison E., Gibertini I., Diot P., Carpentier E, et al. Characteristics of Endobronchial Primitive Tumors in Children. Pediatric Pulmonol. 2014. 49:121–5.

5.Skuladottir H., Hirsch FR., Hansen HH., Olsen JH. Pulmonary neuroendocrine tumors: incidence and prognosis of histological subtypes. A population-based study in Denmark. Lung Cancer. 2002. 37:127–35.

6.Divisi D., Crisci R. Carcinoid tumors of the lung and multimodal therapy. Thorac Cardiovasc Surg. 2005. 53:168–72.

7.Fink G., Krelbaum T., Yellin A., Bendayan D., Saute M., Glazer M, et al. Pulmonary carcinoid: pre- sentation, diagnosis, and outcome in 142 cases in Israel and review of 640 cases from the literature. Chest. 2001. 119:1647–51.

8.Kulke MH., Mayer RJ. Carcinoid tumors. N Engl J Med. 1999. 340:858–68.

9.Travis WB. The concept of pulmonary neuroendocrine tumors. Travis WB, Brambilla E, Muller-Hermeli HK, Harris CC, editors. editors.Pathology and genetics of tumours of lung, pleura, thymus, and heart. Lyon: IARC Press;2004. p. 19–20.

10.Steven RB. Glenna BW. Emphysema and Overinflation. Robert MK, Bonita FS, Joseph WS, Nina FS, Richard EB, editors. editors.Nelson Textbook of Pediatrics. 19th ed.Philadelphia: Elsevier saunders;2011. p. 1460–1461.