Lung Sparing Bronchoplasty of Carcinoid Tumors with Single Lumen ETT in a Limited-Resource Hospital Setting

Special Article: Sarcoma Surgery

Austin J Surg. 2023; 10(3): 1308.

Lung Sparing Bronchoplasty of Carcinoid Tumors with Single Lumen ETT in a Limited-Resource Hospital Setting

Maham Zehra Zaidi1*; Niaz Hussain2; Ayesha Siddiqua Hashmi3; Syed Suhail Qadri4#; Saima Imam5#; Shagufta Nasreen6#; Hina Khalid7#

1House Officer in Dow University of Health Sciences, Pakistan

2Associate Professor and Head of Department of Thoracic Surgery in Dow University of Health Sciences, Pakistan

3Post Graduate Resident in Dow University of Health Sciences, Pakistan

4Cardiothoracic Surgeon in Castle Hill Hospital, Pakisthan, Pakistan

5Consultant Anesthetist in Dow University of Health Sciences, Pakistan

6Post graduate Resident in Dow University of Health Sciences, Pakistan

7Post Graduate Surgical Resident in Dow University of Health Sciences, Pakistan

*Corresponding author: Maham Zehra Zaidi House Officer in Dow University Health Sciences, Pakistan. Email: mahamzehrazaidi@gmail.com

#These authors have contributed equally to this artcle.

Received: June 05, 2023 Accepted: July 05, 2023 Published: July 12, 2023

Abstract

Two patients, who presented with complaints of cough and hemoptysis, were diagnosed as having biopsy proven carcinoid tumor of the airway. Both patients underwent lung sparing surgery and bronchoplasty, with the aid of single lumen ETT in a limited resource, underprivileged hospital setting. This case report underscores the management of resectable tumors of major airways with single lumen ETT.

Keywords: Bronchoplasty; Lung sparing surgery; Bronchopulmonary carcinoid

Introduction

Carcinoid tumor is a slow growing [1] tumor originating in the cells of the neuroendocrine system. However, they can act aggressively and metastasize. It is estimated that approximately 5-6% of patients with a carcinoid tumor will develop carcinoid syndrome [2,3], which correlates with extensive pulmonary or hepatic metastases.

The majority of carcinoids are found to be within the gastrointestinal system (67.5%), and the bronchopulmonary system (25.3%). Nonlocalized lesions were mostly found to be cecal (81.5-83.2%) and pancreatic (71.9-81.3%) carcinoids, whereas localized disease involved the rectum (81.7%), stomach (67.5%), and bronchopulmonary system (65.4%). These neuroendocrine tumors may be functional (showing exaggerated hormone production) or non-functional [4], and may act benign or malignant.

In the past few decades, there has been a remarkable increment in the incidence of carcinoids. It has been reported that at the time of diagnosis, distant metastasis is already present in 12.9% of such cases; with only 67.2% survival among these patients at 5 years, bringing into question the presumptive benignity of this entity [5].

Thus, the need for prompt diagnosis and intent for curative surgery is being highlighted through these case reports, which can be achievable in a limited resources hospital setting.

Case Report

Case 01

A young male, aged 30 years presented with complaints of cough, associated with hemoptysis and fever for the last 2.5 years. He did not have any history of flushing, diarrhea, shortness of breath etc. Chest examination revealed decreased breath sounds on the left side; rest of the examination was normal. Chest x-ray showed slight tracheal deviation towards the right. Further workup was done. CT scan showed a well demarcated, ovoid, hypodense lesion in the left main bronchus measuring 1.5x0.9cm, with hyper-expansion of the left lung and concomitant infection, without any evidence of metastatic lesions elsewhere in the body.

Bronchoscopy was performed, and the mass was identified in the distal part of left main bronchus, which was biopsied. Biopsy results concluded that it was a typical (low grade) carcinoid tumor and plan was made for curative surgery.

Citation: Hussain N, Hashmi AS, Qadri SS, Imam S, Zaidi MZ, et al. Lung Sparing Bronchoplasty of Carcinoid Tumors with Single Lumen Ett in a Limited-Resource Hospital Setting.Austin J Surg. 2023; 10(3): 1308.