Bronchial adenomas.

A series comprising 26 patients with bronchial adenoma, consisting of 23 carcinoid tumours, 2 mucoepidermoid tumours, and 1 cylindroma, treated during the period 1956-71 is presented. Eighteen of the carcinoid adenomas showed invasive growth, and six had metastases, five with lymph node metastases and one with hepatic metastases without node involvement (Case 17) at the time of operation. Both of the mucoepidermoid tumours and the cylindroma showed invasive growth, and one of the former had metastases. The average history of the patients was three to six months. The diagnosis was established preoperatively in 13 cases. It should be stressed that a cytological examination in 21 patients revealed pathological cells in seven. The patients have been treated according to the same principles followed in the case of malignant lung tumours. Four patients died owing to progression of the tumour, two from complicating diseases, and four from postoperative complications. Sixteen patients are alive and have been followed up. Three of these patients have been submitted to a non-curative operation. One year later they show no clinical signs of tumour progression. Twelve patients were submitted to a curative operation six months to 15 years before the follow-up. None shows any signs of recurrence. One patient refused operation. The five-year survival rate for lung carcinoids was 56%, or 68% after exclusion of four immediate postoperative deaths. It is concluded that bronchial adenomas are potentially malignant tumours and should be treated like other malignant lung tumours; because of their slow growth rate and the later development of metastases, extensive operations in cases of invasive tumours and reoperations in cases of recurrence may be carried out with good results. It is further concluded that cytological examinations have greater value than was hitherto assumed.