Parenchyma-Sparing Bronchial Sleeve Resection for Central Typical Endobronchial Pulmonary Carcinoid in a Young Adult: A Case Report.

INTRODUCTION

Pulmonary carcinoid tumors are uncommon neuroendocrine neoplasms. Central endobronchial lesions may cause obstruction, hemoptysis, recurrent infection, and asthma-like symptoms. Surgery aims for complete resection while preserving functional lung parenchyma when feasible.

CASE PRESENTATION: A 26-year-old male smoker presented with an 8-month history of chronic cough, recurrent small-volume hemoptysis, and exertional dyspnea. Chest CT suggested a central right endobronchial lesion. Flexible bronchoscopy showed a smooth polypoid mass obstructing the bronchus intermedius. Bronchial lavage grew Enterobacter species, likely representing secondary post-obstructive colonization or infection, and targeted antibiotics were given. Biopsies confirmed typical carcinoid, supported by synaptophysin positivity and low Ki-67 index. Preoperative testing showed an obstructive spirometric pattern and acceptable blood gas parameter. The patient underwent right posterolateral thoracotomy with bronchial sleeve resection, primary end-to-end anastomosis, and pleural flap reinforcement. Margins were negative, and the postoperative course was uneventful with full lung expansion. This case highlights the value of CT and bronchoscopy, and illustrates how sleeve resection can achieve complete tumor removal while avoiding more extensive lung resection in a young patient.

CONCLUSION

Bronchial sleeve resection is an effective parenchyma-sparing option for selected central endobronchial carcinoids, especially when lung preservation is clinically important.