Neuroendocrine Carcinoid Lung Tumor: A Case Series of an Indolent Tumor

Neuroendocrine tumors (NETs) of the lung are infrequently encountered tumors, constituting a small subset of pulmonary neoplasms. The lung is the second most common site of carcinoid tumors. Most patients experience vague symptoms for many years, making them fairly difficult to diagnose. This case series presents three unique and challenging cases of pulmonary neuroendocrine tumors. Case 1 is a 55-year-old female with a 6-month history of progressive dyspnea and noted to have a lung mass blocking the left main bronchus. The patient underwent bronchoscopy with tissue diagnosis and ultimately needed thoracotomy and left-sided pneumonectomy. Case 2 is a 61-year-old female with a chronic cough for several years who was seen to have a right lung mass, underwent a bronchoscopy showing a Carcinoid tumor, and was taken for a right lower lobe lobectomy. Case 3 is a 75-year-old female who was seen to have a right hilar mass as an incidental finding on CT imaging. The patient underwent bronchoscopy with the biopsy proving carcinoid tumor. The patient had multiple co-morbidities, was not deemed to be a surgical candidate, and was referred for radiation therapy. The patients in the case series presented with nonspecific respiratory symptoms, leading to diagnostic investigations including imaging studies and bronchoscopy evaluation. Histopathological examination revealed a well-differentiated neuroendocrine tumor with positive immunohistochemical staining for neuroendocrine markers. Subsequent staging investigations confirmed localized disease without distant metastasis. Multidisciplinary collaboration involving pulmonologists, oncologists, radiation oncologists, and surgeons played a pivotal role in determining the optimal therapeutic approach. These patients underwent surgical resection, and postoperative pathology confirmed clear margins. Adjuvant therapy was considered based on the tumor characteristics and the overall risk of recurrence.