DISCUSSION: VACTERL association is defined by the presence of at least three of the following congenital malformations: vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies and limb abnormalities. The incidence is between 1/10,000 to 1/40,000 infants. Proposed etiology is likely multifactorial. Genetic etiologies identified in humans with VACTERL include mitochondrial dysfunction, heterozygous mutations in HOXD13 and heterozygous/ hemizygous mutations in ZIC3. Environmental influences implicated include maternal diabetes mellitus, in-utero exposure to estrogen/progesterone compounds and lead. Treatment involves surgical correction of the congenital abnormality. Bronchopulmonary neuroendocrine tumors (BP-NETs) represent a range of malignancies arising from the neuroendocrine cells of the bronchopulmonary epithelium. The 2004 WHO histological classification listed four subtypes: low grade typical carcinoid tumor, intermediate grade atypical carcinoid tumor, large cell neuroendocrine carcinoma and small cell lung carcinoma. They represent 1.2% of primary lung malignancies; incidence in the U.S is 1.57 of 100,000. Typical carcinoid tumors occur more frequently in the fifth and sixth decade of life. Presentations include cough (32%) and hemoptysis (26%). Diagnosis consists of imaging using X-ray, CT scan and/or the combination of Somatostatin Receptor Scintigraphy (SRS) and PET scan followed by biopsy. Treatment involves surgical resection.