Atypical endobronchial carcinoid tumor: A case report

Atypical Carcinoid Tumors are rare neoplasms derived from neuroendocrine cells. They are classified into two types: typical and atypical carcinoids. Atypical carcinoids are more aggressive than typical ones, with a higher risk of metastasis. They are distinguished by specific microscopic characteristics, such as a higher cellular proliferation index. The main treatment for endobronchial carcinoids is surgical, followed by close monitoring due to the risk of recurrence or metastasis.

We report the case of a 55-year-old man, with no significant medical history and no respiratory symptoms, who was diagnosed with an atypical endobronchial carcinoid tumor. The patient presented for preoperative evaluation related to gallstone disease, during which a chest X-ray revealed a left-sided thoracic opacity, leading to further investigations. A computed tomography (CT) scan showed an endobronchial mass, along with calcifications and mediastinal lymphadenopathy, which are characteristic features of atypical carcinoids. 

Bronchoscopy was performed, revealing a tumor bud obstructing the left main bronchus. A bronchial biopsy confirmed the presence of atypical cells, supported by positive immunohistochemical markers such as chromogranin A and synaptophysin. The patient underwent a left pneumonectomy due to the obstruction and the tumor’s aggressive potential, followed by adjuvant chemotherapy to reduce the risk of recurrence.

Postoperative follow-up was established with regular imaging studies to monitor for any potential recurrence. This case highlights the importance of early detection of atypical carcinoid tumors, even in asymptomatic patients, and the need for a multidisciplinary approach to ensure effective treatment and improved prognosis. Although rare, atypical carcinoids can be associated with a less favorable prognosis if not detected at an early stage.