Endobronchial Primitive Neuroectodermal Tumor With Pneumothorax Ex Vacuo.

Area of Science:

• Pulmonology
• Thoracic Surgery
• Oncology

Background:

• Endobronchial primitive neuroectodermal tumors (PNETs) are exceptionally rare primary lung malignancies.
• Accurate and timely diagnosis of endobronchial tumors can be challenging, potentially mimicking other pulmonary conditions.

Observation:

• A patient presented with persistent pneumothorax after tube thoracostomy, initially suggestive of air leak.
• Computed tomography and bronchoscopy revealed a left main bronchus tumor, initially misdiagnosed as small cell lung cancer.
• A left pneumonectomy was performed based on the presumed diagnosis.

Findings:

• Pathological examination confirmed the tumor as a primitive neuroectodermal tumor (PNET), not small cell lung cancer.
• Despite the absence of adjuvant chemoradiotherapy, the patient showed no signs of tumor recurrence post-surgery.

Implications:

• This case highlights the importance of comprehensive pathological evaluation for endobronchial masses, even after initial diagnosis.
• Surgical resection may be a viable primary treatment for localized endobronchial PNETs, with potential for favorable outcomes without adjuvant therapy.
• Further research into the optimal management of rare thoracic PNETs is warranted.