Bronchial carcinoid tumors seldom occur in children, sometimes mistaken for a minor disease and diagnosed slowly. Materials and Methods: We report on a patient who diagnose tumors slowly because confused with asthma.
This case describes a 14-year-old boy, presenting with asthma-like symptoms throughout 3 years. He was treated as asthma but wax and wane. Chest x-ray showed an hyperlucent left lung, so we rechecked high resolution computed tomography (HRCT) for unilateral hyperinflation diseases diagnosis. It was found 1×1㎝ nodule in left main bronchus. We did bronchoscopy and discovered a round mass in the left bronchus, 2∼3㎝ away from carina. In the biopsy, it was bronchial carcinoid tumor, so we resected tumor.
Because symptoms of bronchial carcinoid tumors are various, it can often be misdiagnosed firstly. It is confused with asthma, pneumonia and foreign body. An additional examination were necessary when respiratory symptoms persist.
Pulmonary carcinoid tumors consisting of typical carcinoid tumors (TC) and atypical carcinoid tumors (AC) are rare, accounting for 2–5% of all lung tumors. TC is considered a low-grade tumor with a rate of distant metastasis up to 12%. In contrast, ACs are more aggressive tumors, displaying a metastatic rate up to 70%. Surgery is the treatment of choice; however, the current treatment outcomes of metastatic lung carcinoids are discouraging. This study aimed to investigate the EGFR mutation using the PNA-mediated clamping method and to provide basic data for using EGFR-TK1 and its clinical implications.
A total of 14 cases that underwent surgery were diagnosed as carcinoid tumors and pathologically classified as TC and AC. The paraffin-embedded tissues were analyzed for EGFR mutations using the PNA-mediated PCR clamping technique. The mutant type was noted in the cases with a△Ct greater than 2.0.
Of 14 cases, eight were AC and six cases were TC. No known EGFR mutation was detected with a△Ct less than 2.0.
The EGFR genotype determined using the PNA-mediated PCR clamping method was wild-type in all pulmonary carcinoid tumors. Therefore, the application of EGFR-TK1 is limited in pulmonary carcinoid tumors.
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