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N. Fernandez



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    P1.07 - Poster Session 1 - Surgery (ID 184)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P1.07-046 - clinical and pathological profile of lung carcinoid (ID 3235)

      09:30 - 16:30  |  Author(s): N. Fernandez

      • Abstract

      Background
      Carcinoid tumours have been reported in a wide range of organs, but they most commonly involve lungs and gastrointestinal tract. Pulmonary or bronchial carcinoid tumours account for over 25% of all carcinoid tumours and for 2% of all pulmonary neoplasms. Approximately 10-20% of pulmonary carcinoids are atypical, the remaining 80-90% are typical. It was generally accepted that carcinoid tumours were very slow-growing and benign neoplasm with no potential for invasiveness and no tendency to develop metastases.

      Methods
      This study includes 60 consecutive carcinoid patients referred to the Department of Thoracic Surgery, for surgical treatment, between 1989 to 2011. The study includes all patients treated at the unit during the study period. The inclusion criteria was a histopathologically verified carcinoid tumor. Tumor specimens were obteined at operation.

      Results
      According to the histological findings, 47 patients (22 male and 25 female patients) had a typical carcinoid tumor, and 13 patients (8 male and 5 female patients) had an atypical carcinoid tumor. All patients were treated with curative surgery: 50 patients had not progressed, 4 had recurrence and in 6 the follow-up was lost. Among patients with typical carcinoid tumor, 37.2% smoked >10 pack-years at the time of diagnosis, while in atypical tumors 69.2% were heavy smokers. The majority of patients in our series presented evidence of bronchial presentation (87.5%), obstructive pneumonitis (78.8%), pleuritic pain (70.7%), pulmonary atelectasis (75.0%), and dyspnea (56.1%). This was followed by cough (75.9%), hemoptysis (41.8%), and a variety of other symptoms/signs, including weakness, nausea, weight loss, night sweats, and neuralgia. The lesions ranged in size from 0.4 to 7 cm, with 35% of the neoplasm having a maximum dimension >3.0 cm. Histological examination of samples showed oncocytic (4 cases), papillary (4 cases) and mixed trabecular/insular/organoid (52 cases) patterns. The growth pattern of carcinoid samples was polypoid (23 cases), nodular (16 cases), hourglass (11cases), stenotic (3 cases), and lobular (1 case).

      Conclusion
      The goal of this work is not so much to recapitulate lung carcinoids tumors classification but rather to provide an understanding of their clinico-pathological profiles. Although incidence of newly diagnosed patients with carcinoid tumors of the lung is low, the long survival for those with low and intermediate differentiation grade, and the deeper knowledge we now have on molecular processes that governs tumors growth make these tumors a challenging field in Oncology.