Angioedema as a single manifestation of carcinoid syndrome in a bronchial carcinoid tumor.
BACKGROUND
The association of bronchial carcinoid tumours with carcinoid syndrome is extremely rare especially in the absence of metastasic disease, and the angioedema is not a typical sign of this syndrome.


RESULTS
We report the case of a 39 year-old woman referred to our allergy department with recurrent episodes of angioedema. The aetiological study of angioedema did not show evidence of hypersensitivity to common inhalants, food allergens and latex. C1-inhibitor, C3, C4, C1q, proteinogram and immunoglobulins (IgA, IgG, IgM) all were normal. TSH determination gave normal results, too. Faecal analyses for parasites were negative. The haemogram showed moderate leucocytosis and hypocromic mycrocitic anaemia. The thoracic radiography showed a mediastinal node image in the right paratracheal region. Histology analyses of the samples were diagnostic of a typical carcinoid tumor. Levels of 5-hydroxyindolacetic acid (5-HIIA) were slightly increased. A superior lobectomy was performed and no new episodes of angioedema appeared after surgical intervention.


CONCLUSIONS
We report the first case of typical bronchial carcionid tumour, without metastasic disease, with angioedema as a single manifestation of carcinoid syndrome. In our knowledge, only one case of Quincke's edema as part of typical carcinoid syndrome has been reported, in a case of primary midgut carcinoid tumor with metastasic disease to liver. It is very important to include complementary tests, as thoracic radiography, in the routine study of angioedema to reject malignant diseases.
Allergy Department, San Pedro de Alcántara Hospital, Cáceres, Spain. trabadoro@yahoo.es
A
A
Rodríguez Trabado
J A
JA
Riesco Miranda
S
S
Porcel Carreño
E
E
Rodríguez Martín
C
C
Fletes Peral
S
S
Jiménez Timón
M
M
Alvarado Arenas
J
J
Hernández Arbeiza
R
R
Cobo López
D000328:Adult; D000799:Angioedema / Q000209:etiology*; D001984:Bronchial Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery / Q000652:urine; D001999:Bronchoscopy; D002276:Carcinoid Tumor / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery / Q000652:urine; D005260:Female; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine; D008207:Lymphatic Metastasis; D008303:Malignant Carcinoid Syndrome / Q000209:etiology* / Q000652:urine; D010257:Paraneoplastic Syndromes / Q000209:etiology*; D011859:Radiography; D012008:Recurrence; D012074:Remission Induction; D012701:Serotonin / Q000378:metabolism
D012701:Serotonin; D006897:Hydroxyindoleacetic Acid