AN INCIDENTAL FINDING OF TYPICAL CARCINOID

TOPIC: Lung Pathology TYPE: Medical Student/Resident Case Reports INTRODUCTION: Typical carcinoid is a rare neuroendocrine tumor (NET); they represent 1 to 2% of all lung malignancies in adults. NETs are more common than atypical carcinoid, characterized by low mitotic rate. Risk factors remain unclear; most cases sporadic. We present the case an asymptomatic woman diagnosed with typical tumor. CASE PRESENTATION: 59-year-old past medical history significant for hyperlipidemia, non-alcoholic fatty liver disease, and smoking 9 pack-years. After findings on dose computed tomography (CT) right middle lobe nodule as part routine cancer screening, she was referred our Pulmonary clinic. Subsequently, High-Resolution CT chest confirmed 11 x 10 mm that suspicious malignancy, well fibrotic changes apices atelectasis left base. Abdominal showed no abnormalities. On history, denied any symptoms. Routine laboratory work up, physical examination pulmonary function test were unremarkable. She underwent Electromagnetic Navigational Bronchoscopy (ENB) biopsy lesion. Histopathologic lung, figures averaging less per high power field, cells positive keratin, TTF-1, chromogranin, synaptophysin, Ki-67 proliferation index 5%. Afterward, evaluated thoracic surgery; due centrally located tumor, decision made proceed lobectomy mediastinal lymph node dissection, performed via limited thoracotomy. Her postoperative period progressed without complications. DISCUSSION: usually considered benign However, occasional metastases do occur. Symptoms often nonspecific or absent, which could lead delay diagnosis. Complete surgical resection tumors preservation uninvolved parenchyma curative early stages, risk recurrence very low. Due location patient's surgery treatment choice. Nodal involvement histological subtype important factor prognosis. CONCLUSIONS: complexity NET requires multidisciplinary approach long term follow up. Our patient will require close up monitoring imaging surveillance. REFERENCE #1: Wang Z, Yang MQ, Huang WJ, Zhang D, Xu HT. Sclerosing pneumocytoma mixed tumor: A report review literature. Medicine (Baltimore). 2019 Feb;98(5):e14315. doi: 10.1097/MD.0000000000014315. PMID: 30702609; PMCID: PMC6380861. #2: Nilforoshan M, Matus IA. Combined Carcinoid-Adenocarcinoma Tumor. J Bronchology Interv Pulmonol. 2017 Apr;24(2):e23-e25. 10.1097/LBR.0000000000000359. 28323740. #3: Demirci I, Herold S, Kopp A, Flaßhove Klosterhalfen B, Janßen H. Overdiagnosis adenocarcinoma lung: World Surg Oncol. 2012 Jan 23;10:19. 10.1186/1477-7819-10-19. 22269186; PMC3317839. DISCLOSURES: No relevant relationships Felix Hernandez, source=Web Response Jeany Villamizar,