Bronchial Adenoma Follow-up

  • Author: Charles W Van Way III, MD; Chief Editor: Zab Mosenifar, MD   more...
 
Updated: Oct 22, 2010
 

Further Outpatient Care

Chemotherapy and radiotherapy can be instituted if indicated, as discussed in Medical Care.

Next

Transfer

If the endoscopist is not prepared to deal with airway bleeding, biopsy should be deferred until the patient has been sent to an appropriate facility.

Previous
Next

Deterrence/Prevention

No preventive regimen has been established. Smoking cessation is always a good thing but has no specific effect on these tumors.

Previous
Next

Complications

Perioperative complications include the following:

  • Delayed hemorrhage
  • Bronchial anastomotic leak
  • Bleeding and coagulopathy
  • Myocardial ischemia
  • Atelectasis or pneumonia
  • Respiratory failure, need for persistent mechanical ventilation
  • Mucoepidermoid carcinoma - Known to result in intracranial metastases, even in cases of minimal bronchial wall involvement
  • Carcinoid - Solid organ metastases (eg, to the liver) possible
Previous
Next

Prognosis

The overall 5-year patient survival rates for bronchial adenomas are excellent at approximately 96%. Scattered reports describe local recurrences or distant metastases following adequate resection of typical lesions.

Carcinoids

The slow growth pattern of carcinoids often prolongs the natural history of the disease process. A 5-year patient survival rate of 92% and 10-year survival rate of 88% has been reported for typical carcinoids treated with complete resection and formal mediastinal dissection. These excellent results applied to patients with both N1 and N2 disease, although those with N2 status received adjunctive radiation therapy. In atypical carcinoids, the survival rate is decreased to 60% at 5 years and 49% at 10 years.

Adenoid cystic carcinoma

After resection, the 5-year survival rate is approximately 83% and the disease-free survival rate is 60%. Patients with adenoid cystic carcinoma have an excellent prognosis because the tumor grows slowly and is radiosensitive. The best results are achieved when complete resection is accomplished; however, prolonged patient survival is possible even with incomplete resection.

Mucoepidermoid carcinoma

The 5-year survival rate is 11.1%. This tumor is known to cause intracranial metastases, even in the presence of minimal bronchial wall involvement. Chemotherapy and radiation are used mainly for palliation.

Previous
Next

Patient Education

For excellent patient education resources, visit eMedicine's Procedures Center. In addition, see eMedicine's patient education article Bronchoscopy.

Previous
 
Contributor Information and Disclosures
Author

Charles W Van Way III, MD  Professor, Department of Surgery, Sosland/Missouri Endowed Chair of Trauma Services, Director, Shock/Trauma Research Center, University of Missouri Kansas City School of Medicine

Charles W Van Way III, MD is a member of the following medical societies: American Association for Thoracic Surgery, American College of Chest Physicians, American College of Critical Care Medicine, American College of Physician Executives, American College of Surgeons, American Medical Association, American Medical Informatics Association, American Society for Clinical Nutrition, American Society for Nutritional Sciences, American Society for Parenteral and Enteral Nutrition, American Surgical Association, Association of Military Surgeons of the US, Central Surgical Association, Missouri State Medical Association, Shock Society, and Southwestern Surgical Congress

Disclosure: Baxter, Inc Consulting fee Consulting

Coauthor(s)

Gerald L Early, MD, MA, FACS, FCCP  Associate Professor, Department of Surgery, University of Missouri-Kansas City

Gerald L Early, MD, MA, FACS, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Surgeons, American Medical Association, Society of Critical Care Medicine, and Society of Thoracic Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael Peterson, MD  Chief of Medicine, Vice-Chair of Medicine, University of California at San Francisco; Endowed Professor of Medicine, University of California at San Francisco-Fresno

Michael Peterson, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Daniel R Ouellette, MD, FCCP  Associate Professor of Medicine, Wayne State University School of Medicine; Consulting Staff, Pulmonary Disease and Critical Care Medicine Service, Henry Ford Health System

Daniel R Ouellette, MD, FCCP is a member of the following medical societies: American College of Chest Physicians and American Thoracic Society

Disclosure: Boehringer Ingleheim Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching; Astra Zeneca Honoraria Speaking and teaching

Timothy D Rice, MD  Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, St Louis University School of Medicine

Timothy D Rice, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Physicians

Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD  Director, Division of Pulmonary and Critical Care Medicine, Director, Women's Guild Pulmonary Disease Institute, Professor and Executive Vice Chair, Department of Medicine, Cedars Sinai Medical Center, University of California, Los Angeles, David Geffen School of Medicine

Zab Mosenifar, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, and American Thoracic Society

Disclosure: Nothing to disclose.

Acknowledgments

The authors acknowledge the contributions of Ellis Salloum, MD, who was a coauthor on the original version of this article.

References

  1. Cetinkaya E, Aras G, Sokucu SN, Ozgül A, Altin S. Treatment of endoluminal typical carcinoid tumor with bronchoscopic techniques. Tuberk Toraks. 2009;57(4):427-30. [Medline].

  2. Cutz E. Neuroendocrine cells of the lung. An overview of morphologic characteristics and development. Exp Lung Res. Nov 1982;3(3-4):185-208. [Medline].

  3. D'Agati VD, Perzin KH. Carcinoid tumorlets of the lung with metastasis to a peribronchial lymph node. Report of a case and review of the literature. Cancer. May 15 1985;55(10):2472-6. [Medline].

  4. Aguayo SM, Miller YE, Waldron JA Jr, Bogin RM, Sunday ME, Staton GW Jr, et al. Brief report: idiopathic diffuse hyperplasia of pulmonary neuroendocrine cells and airways disease. N Engl J Med. Oct 29 1992;327(18):1285-8. [Medline].

  5. Dagostino RS, Ponn RB. Adenoid Cystic Carcinoma and Other Primary Salivery Gland-Type Tumors of the Lung. In: Shields TW, LoCicero J 3rd, Ponn RB, Rusch VW, eds. General Thoracic Surgery. 6th ed. Philadelphia, Pa: Lippincott, Williams & Wilkins; 2005:1768-77.

  6. Darling G, Ginsberg RJ. Carcinoid Tumors. In: Shields TW, LoCicero J 3rd, Ponn RB, Rusch VW, eds. General Thoracic Surgery. 6th ed. Philadelphia, Pa: Lippincott, Williams & Wilkins; 2005:1753-67.

  7. Davini F, Gonfiotti A, Comin C, Caldarella A, Mannini F, Janni A. Typical and atypical carcinoid tumours: 20-year experience with 89 patients. J Cardiovasc Surg (Torino). Dec 2009;50(6):807-11. [Medline].

  8. Faber LP. Sleeve Lobectomy. In: Shields TW, LoCicero J 3rd, Ponn RB, Rusch VW, eds. General Thoracic Surgery. 6th ed. Philadelphia, Pa: Lippincott, Williams & Wilkins; 2005:458-69.

  9. Fink G, Krelbaum T, Yellin A, Bendayan D, Saute M, Glazer M, et al. Pulmonary carcinoid: presentation, diagnosis, and outcome in 142 cases in Israel and review of 640 cases from the literature. Chest. Jun 2001;119(6):1647-51. [Medline].

  10. Goldberg M, Patchefsky AS. Uncommon Tumors of the Tracheobronchial Tree: Diagnosis and Management. Chest Surg Clin North Amer. 2003;13:1-174.

  11. Kirshbom PM, Harpole DH Jr. Bronchial Gland Tumors. In: Pearson FG, Cooper JD, Deslauriers J, Ginsberg RJ, Hiebert CA, Patterson GA, Urschel HC, eds. Thoracic Surgery. 2nd ed. New York, NY: Churchill Livingstone; 2002:763-71.

  12. Lawson RM, Ramanathan L, HurleyG, Hinson KW, Lennox C. Bronchial adenoma: review of an 18-year experience at the Brompton Hospital. Thorax. 1976;31:245-253.

  13. Litzky L. Epithelial and soft tissue tumors of the tracheobronchial tree. Chest Surg Clin N Am. Feb 2003;13(1):1-40. [Medline].

  14. Parsons RB, Milestone BN, Adler LP. Radiographic assessment of airway tumors. Chest Surg Clin N Am. Feb 2003;13(1):63-77, v-vi. [Medline].

  15. Rea F, Rizzardi G, Zuin A, et al. Outcome and surgical strategy in bronchial carcinoid tumors: single institution experience with 252 patients. Eur J Cardiothorac Surg. Feb 2007;31(2):186-91. [Medline].

  16. Scott WJ. Surgical treatment of other bronchial tumors. Chest Surg Clin N Am. Feb 2003;13(1):111-28. [Medline].

  17. Warren WH, Faber LP. Bronchoscopic Evaluation of the Lungs and Tracheobronchial Tree. In: Shields TW, LoCicero J 3rd, Ponn RB, Rusch VW, eds. General Thoracic Surgery. 6th ed. Philadelphia, Pa: Lippincott, Williams & Wilkins; 2005:284-98.

  18. Watanabe Y. Tracheal Sleeve Pneumonectomy. In: Shields TW, LoCicero J 3rd, Ponn RB, Rusch VW, eds. General Thoracic Surgery. 6th ed. Philadelphia, Pa: Lippincott, Williams & Wilkins; 2005:486-95.

  19. Whyte RI, Ferguson MK. Preoperative Preparation of Patients for Thoracic Surgery. Thor Surg Clin. 2005;15:185-322.

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.