Removal of multifocal neuroendocrine lung tumours with a LIMAX® 120 Nd:YAG laser: case report
Journal of Cardiothoracic Surgery volume 10, Article number: A23 (2015)
Multifocal neuroendocrine lung tumours are rare. When they are nonetheless diagnosed there is uncertainty as to how treatment should proceed. We present such a case. Our decision was to surgically remove all the lung foci visible on thoracic computer tomography.
The patient was a 69-year-old woman. Computer tomography of the thorax carried out after a road traffic accident revealed bilateral lung foci measuring up to 1.5 cm. The patient showed no lung symptoms.
A transbronchial biopsy was not able to clarify the cause of the foci. Two of the lung foci were removed by non-anatomical resection using video thoracoscopy. Histological examination of the material surprisingly revealed two typical carcinoid tumours (Ki67 index < 1%). As all the remaining foci were considered to be resectable the interdisciplinary tumour board recommended resection of all lesions. We performed open bilateral resection on a total of 14 foci (six in the right lung and eight in the left). Each of the lung foci was removed non-anatomically in sane with the LIMAX® 120 (Gebrüder Martin & CoKG, Tuttlingen, Germany) diode-pumped Nd:YAG laser. Radical mediastinal lymphadenectomy was also carried out bilaterally. None of the X removed lymph nodes showed metastatic foci. The operations were carried out 4 weeks apart. Postoperative complications did not occur.
Three years later, imaging revealed neither local recurrence nor new lung foci.
Multifocal neuroendocrine lung tumours are often diagnosed coincidentally. If they appear to be resectable, the goal should be non-anatomical resection of all foci. The Nd:YAG laser LIMAX® 120 is special suitable for this, even with a large number of tumours. In the most favourable case a lasting cure can be achieved.
Written informed consent was obtained from the patient for publication of this abstract and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.
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Kirschbaum, A., Rexin, P., Rinke, A. et al. Removal of multifocal neuroendocrine lung tumours with a LIMAX® 120 Nd:YAG laser: case report. J Cardiothorac Surg 10 (Suppl 1), A23 (2015). https://doi.org/10.1186/1749-8090-10-S1-A23
- Carcinoid Tumour
- Ki67 Index
- Road Traffic Accident
- Metastatic Focus
- Tumour Board