Abstract
Background: Carcinoid tumors are low grade, malignant, neuroendocrine neoplasms. Although rare,
they represent the most common primary bronchial tumours in childhood. The aim of
our study was to analyse the long-term survival and surgical treatment outcome in
our young patients operated for carcinoid tumour.
Patients: We retrospectively reviewed the data of 15 paediatric patients who underwent surgery
at our Institution. There were 11 male and 4 female patients with a median age of
15 years (range 8–18). All carcinoids were centrally located and symptomatic.
Results: We performed 10 (66.7%) parenchyma-saving procedures (5 sleeve lobectomies, 3 sleeve
resections of the main bronchus, 2 bronchoplasties associated with lung resection)
and 5 (33.3%) standard resections (3 bilobectomies and 2 lobectomies). There were
13 typical and 2 atypical carcinoids. Three patients (20%) had nodal metastases. There
were no surgery-related deaths or complications. At long-term follow-up all patients
presented with regular growth and all but one are alive. Two (13.3%) patients needed
re-operation.
Conclusions: Results suggest that, in experienced and skilled hands, conservative procedures are
the treatment of choice for the management of paediatric bronchial carcinoids. Relapses
can be successfully treated with re-operation and they can occur even after many years,
underlining the importance of long-term follow-up.
Key words
childhood bronchial carcinoid tumor - sleeve resection - bronchoplasty
References
- 1
Fink G, Krelbaum T, Yellin A. et al .
Pulmonary carcinoid: presentation, diagnosis, and outcome in 142 cases in Israel and
review of 640 cases from literature.
Chest.
2001;
119
1647-1651
- 2
Modlin IM, Sandor A.
An analysis of 8305 carcinoid tumors.
Cancer.
1997;
79
813-829
- 3
Wang LT, Wilkins
Jr
EW, Bode HH.
Bronchial carcinoid tumors in pediatric patients.
Chest.
1993;
103
1426-1428
- 4
Al-Qahtani AR, Di Lorenzo M, Yazbeck S.
Endobronchial tumors in children: Institutional experience and literature review.
J Pediatr Surg.
2003;
38
((5))
733-736
- 5
Ducrocq X, Thomas P, Massard G. et al .
Operative risk and prognostic factors of typical bronchial carcinoid tumors.
Ann Thorac Surg.
1998;
65
410-414
- 6
Travis WD, Rush W, Flieder DB. et al .
Survival analysis of 200 pulmonary neuroendocrine tumors with clarification of criteria
for atypical carcinoid and its separation from typical carcinoid.
Am J Surg Pathol.
1998;
22
934-944
- 7
Filosso PL, Rena O, Donati G. et al .
Bronchial carcinoid tumors: surgical management and long-term outcome.
J Thorac Cardiovasc Surg.
2002;
123
303-309
- 8
Massard G, Ducrocq X, Thomas P. et al .
Typical carcinoid tumors of the bronchi: an update.
J Cardiovasc Surg.
2002;
43
16-21
- 9 Travis WD, Colby TV, Corrin B.
Histological typing of lung and pleural tumours. 3rd ed. Berlin: Springer 1999
- 10
Hartman GE, Shochat SJ.
Primary neoplasms of childhood: a review.
Ann Thorac Surg.
1983;
36
108
- 11
Bellah RD, Mahboubi S, Berdon WE.
Malignant endobronchial lesions of adolescence.
Pediatr Radiol.
1992;
22
563
- 12
Hage R, Brutel de la Riviere A. et al .
Update in pulmonary carcinoid tumors: a review article.
Ann Surg Oncol.
2003;
10
697-704
- 13
Ferguson MK, Landreneau RJ, Hazelrigg SR. et al .
Long-term outcome after resection for bronchial carcinoid tumors.
Eur J Cardiothorac Surg.
2000;
18
156-161
- 14
Cardillo G, Sera F, Di Martino M. et al .
Bronchial Carcinoid tumors: nodal status and long-term survival after resection.
Ann Thorac Surg.
2004;
77
1781-1785
- 15
Curtis JM, Lacey D, Smyth R. et al .
Endobronchial tumours in childhood.
Eur J Radiol.
1998;
29
11-20
- 16
Fauroux B, Aynie V, Larroquet M. et al .
Carcinoid and mucoepidermoid bronchial tumours in children.
Eur J Pediatr.
2005;
164
748-752
- 17
Lee GH, Dietrich RB, Pais . et al .
Pediatric case of the day. Neuroendocrine carcinoma (atypical carcinoid/Kulchitzky-cell
carcinoma II).
Radiographics.
1994;
14
((1))
188-191
- 18
Capovilla M, Kambouchner M, Bernier M. et al .
Late cerebellar relapse of a juvenile bronchial carcinoid.
Clin Lung Cancer.
2007;
8
((5))
339-341
- 19
Kaplan KA, Beierle EA, Faro A. et al .
Recurrent pneumonia in children: A case report and approach to diagnosis.
Clin Pediatr.
2006;
45
15-22
- 20
Moraes TJ, Langer JC, Forte V. et al .
Pediatric pulmonary carcinoid: A case report and review of literature.
Pediatr Pulmonol.
2003;
35
318-322
- 21
MacCaughan BC, Martini N, Bains MS.
Bronchial carcinoids. Review of 124 cases.
J Thorac Cardiovasc Surg.
1985;
89
8-17
- 22
Rea F, Rizzardi G, Zuin A. et al .
Outcome and surgical strategy in bronchial carcinoid tumors: single institution experience
with 252 patients.
Eur J Cardiothorac Surg.
2007;
31
((2))
186-191
- 23
Cavaliere S, Foccoli P, Toninelli C.
Curative bronchoscopic laser therapy for surgically resectable tracheobronchial tumors.
J Bronchology.
2002;
9
90-95
- 24
Rizzardi G, Marulli G, Bortolotti L. et al .
Sleeve resections and bronchoplastic procedures in typical central carcinoid tumours.
Thorac Cardiovasc Surg.
2008;
56
((1))
42-45
- 25
Wilkins Jr EW, Grillo HC, Moncure AC. et al .
Changing times in surgical management of bronchopulmonary carcinoid tumor.
Ann Thorac Surg.
1984;
38
339-344
- 26
Rea F, Loy M, Bortolotti L. et al .
Morbidity, mortality, and survival after bronchoplastic procedures for lung cancer.
Eur J Cardiothorac Surg.
1997;
11
201-205
- 27
Deslauriers J, Gregoire J, Jacques LF. et al .
Sleeve lobectomy versus pneumonectomy for lung cancer: a comparative analysis of survival
and sites or recurrences.
Ann Thorac Surg.
2004;
77
1152-1156
- 28
Toker A, Bayrak Y, Dilege S. et al .
G. Bronchial sleeve resections for carcinoid tumor in the first decade of life.
Interact Cardiovasc Thorac Surg.
2004;
3
((2))
280-282
- 29
Gaissert HA, Mathisen DJ, Grillo HC. et al .
Tracheobronchial sleeve resection in children and adolescents.
J Pediatr Surg.
1994;
29
((2))
192-197
- 30
Thomas CF, Tazelaar HD, Jett JR.
Typical and atypical pulmonary carcinoids: Outcome in patients presenting with regional
lymph node involvement.
Chest.
2001;
119
1143-1150
Correspondence
Dr. G. RizzardiMD
Thoracic Surgery
Cardio-vascular-thoracic Science
via Giustiniani 2 Padova
35100 Padova
Italy
Phone: +39/049/821 22 37
Fax: +39/040/821 13 33
Email: giorizz@hotmail.com
