Carcinoid Lung Tumors Clinical Presentation

Updated: Jan 14, 2017
  • Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: Jeffrey C Milliken, MD  more...
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Presentation

History and Physical Examination

About 25% of patients with pulmonary carcinoid tumors are asymptomatic at the time of discovery.

In symptomatic patients, the most common clinical findings are those associated with bronchial obstruction, such as persistent cough, hemoptysis, and recurrent or obstructive pneumonitis. Wheezing, chest pain, and dyspnea also may be noted.

Although uncommon, various endocrine or neuroendocrine syndromes can be initial clinical manifestations of either typical or atypical pulmonary carcinoid tumors. Carcinoid syndrome, hypercortisolism and Cushing syndrome, inappropriate secretion of antidiuretic hormone (ADH), increased pigmentation secondary to excess melanocyte-stimulating hormone (MSH), and ectopic insulin production resulting in hypoglycemia are some of the endocrinopathies that can be produced by a pulmonary carcinoid tumor in a patient who is otherwise asymptomatic.

In cases of malignancy, the presence of metastatic disease can produce weight loss, weakness, and a general feeling of ill health. Carcinoid syndrome is observed most commonly when metastatic disease to the liver is present.