Bronchial Carcinoid Tumors - Evaluation of our Experience in Diagnosis, Treatment and Results in the Patients of Massih Daneshvari Hospital between 1996-2007

Bronchial carcinoids are rare, slow growing neoplasms with nonspecific clinical signs which can mimic many respiratory syndromes. To evaluate clinical presentations, diagnosis and modes of treatment of these tumors in long term, a clinical research was performed in our center. The aim of this presentation is to report our experience.

By completing the prepared computerized data sheets for these patients and use of SPSS and Access softwares and Fisher exact and Mc Nemar tests, informations about age, sex, clinical signs, Hx of smoking, diagnosis and the results were evaluated. The evaluation took eleven years (1996-2007) therapies, with a complete follow up in 86.4% of the patients.

73 patients (38 women, 35 men) with mean age 41.4 years-old (range 11-70) were treated, with diagnosis of bronchial carcinoids. Surgical resections (from wedge resection to pneumonectomy) with or without mediastinal lymph node dissection (MLND) were performed. Other therapies such as bronchoscopic resections or ND YAG laser ablation were done before surgery in some patients. There were two recurrences both in lymphatics (2.7%). During this period 6 patient's (8.2%) have been died, 4 from operated patients (%6 of total operated ones) and one due to surgical complication and 2 were among non-operated ones (28.6% of non-operated cases).

Bronchial carcinoids with slow progression are often treated as other diagnoses before definite diagnosis. Fiberoptic bronchoscopy is more accurate in their findings than rigid broncoscopy (P= 0.04), were as considering that rigid bronchoscope should be available during biopsy time due to the high risk of hemorrhage. Their treatment is surgical resection (maintaining as much paranchyma as possible) with mediastinal lymph node dissection especially in atypical ones. Local recurrence was in lymphatics in our patients. When possible, re-resection is the treatment of choice for recurrences. The use of endoscopic resection or laser ablation in finding tumoral origin or in treating obstruction and infection distal to it might be helpful. Role of chemotherapy and radiation aren't clearly obvious.