Bronchopulmonale Karzinoide: klinisches Vorgehen bei einer seltenen Tumorentität

Typische und atypische Karzinoide der Lunge sind seltene Tumoren mit einer Inzidenz von etwa 0,5 pro 100000 Einwohner. Ein Drittel der Betroffenen bleibt asymptomatisch. Abhängig von Lokalisation, Größe und Wachstum treten Husten, Hämoptysen und pneumonieartige Symptome im Falle einer Obstruktion auf. Die Behandlung ist üblicherweise interdisziplinär. Therapie der Wahl bei lokal begrenzten Karzinoiden ist eine anatomische Resektion.

Abstract

Bronchopulmonary carcinoids are rare neuroendocrine tumors, categorized as either typical (low-grade malignancy) or atypical (intermediate-grade malignancy), with an incidence of approximately 0.5 per 100000 people. One third of patients remain asymptomatic, while others may present with symptoms such as cough, hemoptysis, and recurrent infections, often resulting from bronchial obstruction. Endocrine syndromes, like carcinoid- or Cushing syndrome, are rare in pulmonary carcinoids.

The prognosis of these tumors largely depends on histological classification and disease stage at diagnosis. Typical carcinoids, which are less aggressive, show higher 5- and 10-year survival rates compared to atypical carcinoids. Diagnostic factors such as tumor size, chromogranin A (CgA) levels, and clear differentiation from other lung pathologies, including carcinomas and metastases, are essential for accurate diagnosis and therapy planning.

Due to the rarity of carcinoids, treatment requires an interdisciplinary approach. Surgical resection remains the preferred therapy for localized carcinoids, offering the potential for prolonged survival. Early detection and complete tumor removal are crucial to optimizing outcomes and minimizing the risk of recurrence.

Kernaussagen

• Pulmonale Karzinoide sind seltene Lungentumoren.

• Lungenkarzinoide werden in einen typischen und einen atypischen Subtyp unterteilt.

• Häufig sind pulmonale Karzinoide asymptomatisch und werden zufällig diagnostiziert. Fieber, Dyspnoe und Hämoptysen führen die Patienten zum Arzt.

• Bei der Ausbreitungsdiagnostik sind CT, PET/CT und Bronchoskopie etabliert.

• Die Therapie der Wahl bei pulmonalen Karzinoiden ist die Resektion.

Schlüsselwörter

typisches Karzinoid - atypisches Karzinoid - neuroendokrine Tumoren - minimalinvasive Thoraxchirurgie

Keywords

typical carcinoid - atypical carcinoid - neuroendocrine tumors - minimally invasive thoracic surgery

Publication History

Article published online:
03 June 2025

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