XXII Congresso Brasileiro de Oncologia Clínica

Dados do Trabalho


Título

CASE REPORT: PEDIATRIC PULMONARY NEUROENDOCRINE CARCINOID TUMOR

Apresentação do caso

Patient, 12 years old, leucoderma, from Governador Valadares, MG. It evolved for 6 days with fever, dyspnea and chest pain. A chest radiography was requested, which showed a nodular image on the right hilar topography. A tomography was performed, which showed oval and hypodense mass, with regular contours and partially defined limits, causing luminal narrowing of the middle lobe segmental bronchus and atelectasis of the corresponding lobe, which took the patient to the Pediatric Oncology service. Subsequently, the patient was evaluated by thoracic surgery, who applied a PET/CT for staging, resulting in findings consistent with carcinoid tumor (neuroendocrine). Bronchoscopy and the biopsy were performed, which confirmed the diagnosis. The patient underwent right middle lobectomy with bronchoplasty, lymphadenectomy and thoracostomy, without intercurrences. Surgical specimen referred for pathological analysis, in which a well differentiated neuroendocrine tumor was evidenced, of 2.8 cm and two lymph nodes with reactional lymphoid hyperplasia, without metastasis. In immunohistochemistry, the neoplastic cells were positive for CAM 5.2, synaptophysin and Ki-67 index between 1 and 2%, a typical lung or carcinoid tumor was found. The patient was guided in the postoperative period, quarterly monitoring during the first semester and, later, half-yearly control for up to two years.

Discussão

Tumors carcinoids represent 1% to 5 % of all lung tumors. They are more common in women and, usually diagnosed between 50 and 60 years old. The typical tumors present low degree of malignancy, are well differentiated and show less than two mitoses per 2mm. They have smaller chances of metastasis and show better prognosis. The clinical findings are due to its location, intraluminal growth, metastatic capacity and production of vasoactive amines. The diagnosis of bronchial carcinoids is obtained through a combination of bronchoscopic and radiological studies. The treatment of choice is surgical resection.

Comentários finais

Surgical treatment should be performed whenever possible. The consensual surgical procedures are lobectomy with or without bronchoplasty, isolated pneumectomy or associated with carinectomy, pulmonary resection with resection of the chest wall and removal of ipsilateral mediastinal lymph nodes. Radiotherapy and chemotherapy are not indicated.

Palavras-chave

Neuroendocrine carcinoid tumor; pulmonary tumor; pediatric tumor

Área

Oncologia - Tumores Neuroendócrinos

Autores

MATHEUS VENDRAMINI FURTADO AMARAL, FERNANDO QUEIROZ NUNES SILVA, EMANUELY APARECIDA NUNES, LUCAS FERREIRA GONÇALVES, TAÍS APARECIDA GOMES REIS, TATIANE CHAVES COSTA QUEIROZ, THIAGO AUGUSTO MELO GONTIJO, HUGO HUMBERTO MARÇAL FILHO, GISELLE CUNHA BARBOSA SAFATLE