Pulmonary neuroendocrine (carcinoid) tumor in pediatrics with Mycobacterium tuberculosis coinfection, a case of interest: case report

Tumor neuroendocrino (carcinoide) pulmonar en pediatría con coinfección por Mycobacterium tuberculosis, un caso de interés: reporte de caso

Introduction: Typical bronchial carcinoid tumor is a rare malignant neoplasm of neuroendocrine origin. The clinical presentation is usually nonspecific, and the diagnosis is made by fibrobronchoscopy, histopathologic confirmation and immunohistochemistry. The treatment of choice is complete surgical resection with preservation of lung tissue, with a 20-year survival rate of 94%. This clinical case stands out due to the infrequency and non-specific presentation of a bronchial carcinoid tumor in adolescence, highlighting the importance of recognizing it as an alternative diagnosis in the face of persistent respiratory symptoms without improvement. Clinical case: A male adolescent with a history of recurrent pneumonias and persistent atelectasis in the right lung base. Bronchoscopy showed 100% occlusive endobronchial mass, with pathology and immunohistochemistry confirming the diagnosis of typical carcinoid tumor. After staging studies and normal biochemical markers, it was decided to perform surgery for curative purposes. Resection of the right middle and lower lobe and of the tumor lesion, bronchoplasty and mediastinal lymph node drainage were successfully performed. However, the patient presented stationary evolution due to Pneumonia complicated with pleural effusion and pneumothorax that required antibiotic management for 21 days and closed thoracostomy plus thoracoscopy with decortication. Metastatic tumor involvement was ruled out with octreotide scintigraphy and infectious profile studies were extended which confirmed infection by Mycobacterium tuberculosis. Conclusions: The importance of the diagnostic suspicion of a neoplasm in the management of an adolescent with recurrent pneumonia or atelectasis (in the same location), which is uncommon, where bronchoscopy and computed tomography (CT) could guide the diagnosis.