Bronchial carcinoid tumor in the era of covid-19 pandemic: A case report

新冠疫情时代支气管类癌:病例报告

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Abstract

INTRODUCTION: Bronchial carcinoid tumors are rare, slow growing, malignant neuroendocrine tumors which arise from Enterochromaffin (Kulchitsky) cells. Early diagnosis is extremely important as the main stay of treatment is surgical excision. PRESENTATION OF CASE: We present a rare case of bronchial typical carcinoid tumor in a 27-year-old male who presented with a complaint of intermittent dry cough of 2 weeks' duration associated with shortness of breath and low grade fever. He was initially misdiagnosed as covid-19 pneumonia and was admitted to covid-19 treatment center. Right lung bi-lobectomy with regional lymph node resection was done and he was discharged home in good condition. DISCUSSION: Majority of typical carcinoids are located in the central airways leading to bronchial obstruction with recurrent pneumonia, chest pain and wheezing. In the era of covid-19 pandemic, lung cancer patients are at higher risk of being affected by covid-19 and, early identification and differential diagnosis is extremely difficult in the absence of comprehensive evaluation and work up as the clinical and imaging findings of covid-19 may resemble lung cancer. Although hilar and mediastinal lymph nodes are the most common metastatic sites for typical carcinoids most lymphadenopathies are caused by a reactive inflammatory reaction. CONCLUSION: Bronchial carcinoids are rare, malignant neuroendocrine tumors with complete surgical resection being the only curative management. During the Covid-19 pandemic crisis, diagnosing rare lung diseases like carcinoid tumor is real challenge especially in resource limited set up and needs high index of suspicion with meticulous diagnostic work up. The outcome of typical carcinoids with lymph node metastasis is excellent with complete resection.

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