[Pleural metastases of a typical bronchial carcinoid 7 years after lobectomy]

Bronchial carcinoids are a rare differential diagnosis of solitary pulmonary nodes. Because of their typical manifestation in the major bronchi, carcinoid tumours are visible regularly via bronchoscopy where they show a typical picture. In lymph node-negative disease a favourable outcome can be expected. Typically metastases develop in the lung, liver, brain, bone and adrenal glands.

Seven years after lobectomy of a bronchial carcinoid, a slow-growing thickening of the pleura parietalis was noted in a 54-year-old male patient. No clinical signs of neuroendocrine activity were seen. The histological diagnosis of pleural metastases was established via trans-thoracic punctation. Pleural metastases of bronchial carcinoids are extremely rare. Only two other cases have been reported so far. Palliative cytotoxic chemotherapy was started.

The postoperative prognosis of bronchial carcinoids in lymph node-negative disease is excellent. Metastatic disease--as in the rare case of pleural metastases shown here--remains a therapeutic dilemma. Extensively evaluated concepts for adjuvant or palliative settings do not exist. Further research is needed.