Angela M. Bruno-Ryerson M.D.              St. Luke’s Medical Center
Recurrent endobronchial carcinoid treated with endoscopic laser therapy, brachytherapy, and external beam radiation
         
 

Carcinoid tumors, thought to arise from bronchopulmonary Kulchintsky cells, constitute less than 5% of all primary lung tumors. Overall bronchial carcinoids make up approximately 10% of all carcinoid tumors. Conventional treatment has been surgical resection and recurrence if rare.

A 72 year old male with hemoptysis underwent left lower lobe resection in 1982. After recurrence in 1991, completion pneumonectomy was performed. In 1993, the patient underwent bronchoscopy for recurrent hemoptysis, was again diagnosed with endobronchial carcinoid, now in the posterior segment of the right upper lobe. After treatment with endobronchial YAG laser photoresection and brachytherapy followed by external beam radiation to the right upper lung, the patient has been disease free for 7 years.

Combined Nd YAG laser, brachytherapy and external beam radiation may be a good alternative therapy in cases with recurrent endobronchial carcinoid refractory to surgery. Other non surgical alternatives used in the management of endobronchial tumors include cryotherapy, electrocautery, photodynamic therapy and radiotherapy.