Bronchial carcinoids
Last reviewed: 23.04.2024
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[Symptoms of bronchial carcinoids
Half of the patients are asymptomatic, and half have symptoms of airway obstruction, including dyspnea, wheezing and cough, which often leads to an erroneous diagnosis of bronchial asthma. Also, repeated pneumonia, hemoptysis and chest pain are common. Paraneoplastic syndromes, including Cushing's syndrome due to ectopic ACTH production, acromegaly due to ectopic growth hormone releasing factor and Zollinger-Ellison syndrome due to ectopic gastrin production are more common than carcinoid syndrome, which occurs in less than 3% of patients with a tumor. Noises in the heart associated with changes in the left half of the heart (mitral stenosis or regurgitation) are rare and are caused by valve damage caused by serotonin (as opposed to right-sided valve lesions due to gastrointestinal carcinoid).
Diagnosis of bronchial carcinoids
Diagnosis of bronchial carcinoids is based on bronchoscopic biopsy, but the examination often begins with a computed tomography of the chest, which reveals calcification of the tumor in about a third of patients. Scanning with octreotide labeled with indium-111 is used to determine the extent of the lesion and the spread of metastases. The increased serotonin and 5-hydroxyindoleacetic acid content in the urine confirms the diagnosis, but is rarely detected.
Treatment of bronchial carcinoids
Treatment of bronchial carcinoids is a surgical removal with adjuvant chemotherapy or without.
What is the prognosis of bronchial carcinoids?
Bronchial carcinoids have a different prognosis. It depends on the type of tumor. The five-year survival rate for patients with typical (highly differentiated) carcinoids is above 90%; for atypical tumors, the survival rate is from 50 to 70%.