Management of an LC2 Carinal Carcinoid Tumor Through a Minimally Invasive Parenchymal-Sparing Approach

Objectives

Bronchial neuroendocrine tumors are an uncommon neoplasm of the lungs characterized by an endobronchial mass that mostly arise in the proximal airways. This video demonstrates successful management of an LC2 carinal carcinoid tumor through a minimally invasive, parenchymal-sparing approach.

Methods

A 34-year-old welder presented with a two- to three-year history of wheezing with progressive shortness of breath requiring multiple visits to the emergency room. The preliminary evaluation included a computed tomography scan and flexible bronchoscopy, which demonstrated a lumen-obstructing mass at the LC2 carina with complete left lower lobe collapse. He underwent a bronchoscopic debulking of the tumor with pathology consistent with a carcinoid. A ⁶⁸Ga DOTA-TATE scan did not demonstrate any distant metastatic disease. The patient underwent a video-assisted thoracoscopic resection of the left superior segment of the lower lobe, resection of the left LC2 carina, and bronchoplasty with pleural flap buttressing. Bronchoscopic guidance was employed during the surgery to optimize resection.

Results

The patient was dismissed on postoperative day six with an uneventful hospital course. A bronchoscopy before dismissal demonstrated an intact bronchoplasty. Final pathology confirmed a pT1aN0 typical carcinoid tumor with negative margins.

Conclusion

This video demonstrates a successful parenchymal-sparing LC2 carina resection and bronchoplasty using a VATS approach for a typical carcinoid tumor.

This educational content was originally presented during the STSA 64th Annual Meeting. This content is published with the permission of the STSA. For more information on the STSA and its next Annual Meeting, please click here.