A Case of Pulmonary Typical Carcinoid with Hilar Lymph Node Metastasis

Abstract

Lymph node metastasis from pulmonary typical carcinoid is rare. A 72-year-old man was pointed out a mass shadow with a screening cheat X-ray. A chest computed tomography (CT) showed a 3.1-cm lung tumor in the left lower lobe, which was suspected pulmonary carcinoid with bronchoscopy. Positron emission tomography (PET) revealed an abnormal FDG uptake in the tumor not but any other site. Although he was diagnosed with cT2aN0M0 : Stage IB lung cancer, he rejected surgery. Because the tumor was slightly enlarged during strict observation, he agreed to surgery and underwent left lower lobectomy and hilar and mediastinal lymph node dissection. Pathological findings showed tumor tissue with neither mitosis nor necrosis, tumor cells positive for chromogranin A and a metastatic hilar lymph node, leading to the diagnosis of typical carcinoid, pT2aN1M0 : Stage IIB. He had an uneventful postoperative recovery and was transferred to another institute for rehabilitation eight days after the surgery. We should carefully decide a surgical strategy based on the potential of pulmonary typical carcinoid to metastasize to lymph nodes.