Malignant lung carcinoid tumour

Zainulabid, Ummu Afeera and Abdul Razak, Megat Razeem and How, Soon Hin and Ibrahim, Aishah and Hassan, Nurhidayah and Harun, Norra and Abdul Ghani, Fatimatulzahra (2019) Malignant lung carcinoid tumour. In: Malaysian Thoracic Society Congress 2019, 18th- 21st July 2019, The Royale Chulan Hotel, Kuala Lumpur Malaysia.

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Abstract

*Introduction* Lung carcinoid tumor comprises 1-2% of all lung cancer however atypical lung carcinoid carry high risk of malignant transformation. Carcinoids are strongly and diffusely positive for neuroendocrine markers and commonly used markers include synaptophysin, chromogranin A, and CD56/NCAM. *Case Report* A 43 year old lady presented initially to surgical team with history of chronic diarrhoea for more than 20 times for a year. Further history suggests that she had flushing of the face. She had significant loss of weight nearly 18 kg. OGDS done with normal finding and colonoscope revealed multiple none bleeding cecal diverticulum. Clinically patient had hepatomegaly thus decided by surgical team for CT liver and subsequently CT Thorax (based on CT liver finding). CT liver revealed multiple liver masses and incidental finding of right lung mass. CECT thorax which was ordered subsequently captured a minimally enhancing irregular hypodense mass at medial segment of right lower lobe measuring 4.1 cm x 3.2 cm x 2.2 cm with evident of bone metastasis. Patient was referred to respiratory team for further management. Bronchoscopy was done and noted narrowed opening of right lower lobe medial segment and unable to pass scope further but can see mass at tertiary carina. There is no endobronchial lesion and transbronchial lung biopsy (TBLB) under fluoroscopy was done. Histopathology report is consistent with atypical carcinoid. The neoplastic cells are strong and diffusely positive for Chromagranin A, Synaptophysin, CD56 and focally positive for CK7. A full diagnosis of malignant lung carcinoid with liver and bone metastasis was made and patient was referred to oncology team for Dotatate PET scan, initiation of sandostatin and further management. *Conclusion* Physician should always have high suspicious and include a differential diagnosis of carcinoid syndrome in a patient with chronic diarrhea and flushing despite of its rarity.

Item Type:	Conference or Workshop Item (Poster)
Additional Information:	7459/88223
Subjects:	R Medicine > RC Internal medicine > RC731 Specialties of Internal Medicine-Diseases of The Respiratory System
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine Kulliyyah of Medicine > Department of Internal Medicine
Depositing User:	Asst. Dr. Ummu Afeera Zainulabid
Date Deposited:	04 Feb 2021 12:09
Last Modified:	08 Dec 2022 12:38
URI:	http://irep.iium.edu.my/id/eprint/88223

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