[Bronchial carcinoid in a 7-year-old boy].
A case of a 7-year-old boy admitted to the clinic with severe symptoms of 1-month lasting pneumonia not responding to antibiotics is presented. The chest X-ray confirmed inflammatory process in left lung parenchyma. Due to unsuccessful further preservative treatment, bronchoscopy and CT of the thorax were performed. They showed the presence of a tumor narrowing the left main bronchus. Histopathologic examination of the tissue taken during bronchoscopy revealed carcinoid. Through the left-sided thoracotomy, the resection of a 5 cm large oval-shaped tumor, as well as the distal part of the left main bronchus was done. During clinical observation the child did not present any symptoms of the carcinoid syndrome. Urine levels of acids: homovanillic, vanillylmandelic and 5-hydroxyindolylacetic were normal. Bronchoscopy and X-ray of the chest directly, two weeks after and six months after resection were normal. Childhood primary pulmonary neoplasms are rare and the most frequent malignant tumors are bronchial adenomas. About 80-90% of them are carcinoids. The period from initial symptoms to clinical diagnosis and the institution of treatment, usually lasts several months. In our case it was a seven-week-long period. When cough, weezing, hemoptysis and inflammation of lung parenchyma are prolonged, carcinoid should always be considered in differential diagnosis. Radiological changes are usually nonspecific in cases of bronchial adenomas. Bronchoscopy with biopsy and CT scan are investigations that are decisive. Because of relatively low malignancy of carcinoid, results of the surgical treatment are good even in presence of metastases in regional lymphatic nodules.
Dyjak
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Koła Naukowego przy i Klinice Chorób Dzieci Polsko-Amerykańskiego Instytutu Pediatrii Collegium Medicum Unlwersytetu Jagiellońskiego, Kraków.
D001984:Bronchial Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D001999:Bronchoscopy; D002276:Carcinoid Tumor / Q000175:diagnosis* / Q000601:surgery*; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D013908:Thoracotomy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome