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Pulmonary Procedures |

Rigid Bronchoscopy in Management of Endobronchial Carcinoid Tumor: A Three Year Single Center Experience

Pattabhiraman Vallandaramam, MD; Arjun Srinivasan, DM; Mahadevan Sivaramakrishnan, MD
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KMCH, Coimbatore, India


Chest. 2014;145(3_MeetingAbstracts):484A. doi:10.1378/chest.1834816
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Abstract

SESSION TITLE: Bronchoscopy and Interventional Procedures Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Endobronchial carcinoids are rare forms of primary lung tumors. Traditional management of these tumors has been surgery however rigid bronchoscopic resection can avoid or limit extent of surgery in a subset of these patients.

METHODS: Medical records were retrospectively reviewed for all patients of bronchial carcinoid who underwent rigid bronchoscopy between 2011 and 2013.

RESULTS: Nine patients (6 males and 3 females) with a mean age of 47.5 years (range 31-68) of endobronchial carcinoid were taken up for rigid bronchoscopy. Seven of nine patients had tumors seen in mainstem bronchus (4 left main and 3 right main) and right intermediate bronchus in two patients.Three patients (33.3%) had no extraluminal component (2 typical and 1 atypical) and electrocautery snare ensured complete removal and have not had recurrence after mean follow up of 23.3 months (range 14-28). Six patients (66.6%) had significant extraluminal component or residual intraluminal disease (3 typical and 3 atypical) after rigid bronchoscopy and were advised surgery. In two of these patients rigid bronchoscopy ensured lobe-sparing surgery and in one made pneumonectomy possible. Two patients refused surgery (1 typical and 1 atypical) and have not progressed after mean follow up of 6 months (range5-7) and one patient was lost to follow up.

CONCLUSIONS: Rigid bronchoscopy plays a vital role in diagnosis and management of endobronchial carcinoid tumors irrespective of histology and presence of extraluminal component. It can at best avoid surgery but more often limits extent of surgery.

CLINICAL IMPLICATIONS: Rigid bronchoscopy and debulking should be considered in all patients of endobronchial carcinoid especially those with limited pulmonary reserve before subjecting them to surgery.

DISCLOSURE: The following authors have nothing to disclose: Pattabhiraman Vallandaramam, Arjun Srinivasan, Mahadevan Sivaramakrishnan

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