Central airway carcinoid tumor mimicking chronic asthma and necessitating pneumonectomy: A case report.

INTRODUCTION

Central airway tumors can occasionally be misdiagnosed as a chronic disease. We present a case of a central airway carcinoid tumor that was mistaken as chronic asthma for many years.

PRESENTATION OF CASE: A 29-year-old male bodybuilder presented to our emergency department with shortness of breath and hemoptysis. He was an avid bodybuilder who participated in competitions. He had been diagnosed with asthma for years and used an albuterol inhaler chronically. Computed tomography of the chest showed diffuse opacification of the left hemithorax, multiple air-fluid levels and a 4-cm mass of the proximal left mainstem bronchus with intraluminal calcifications. Bronchoscopy demonstrated a large endobronchial mass, and biopsy was positive for typical carcinoid tumor. Stabilization was achieved with rigid bronchoscopy and partial endobronchial debridement of the tumor to allow some patency to the left lung. After stabilization, he subsequently underwent left pneumonectomy. He recovered well and was discharged home on postoperative day 2. On surveillance 2.5 years after pneumonectomy, he has resumed bodybuilding and has no evidence of recurrent disease.

DISCUSSION: Proximal airway tumors can mimic asthma. Careful management can achieve successful results even in very complex cases. There should be an increased level of suspicion for other diagnoses, especially in young and healthy individuals with asthma that is refractory to medical treatment.

CONCLUSION

Proximal airway tumors can mimic chronic diseases such as asthma. Other diagnoses should be considered, especially in young and health individuals with asthma symptoms that do not respond to conventional therapies.