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Vol.53 No.3 contents | Japanese/English |
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- Case Report -
A Case of a Resected Typical Pulmonary Carcinoid with Mediastinal Lymph Node Metastasis Exhibiting an Elevated Serum Progastrin-Releasing Peptide (pro-GRP) Level
Shutaro Manabe1,2,3, Takuo Shimmyo1, Koji Ando1, Atsushi Mochizuki1, Masayuki Takagi3, Haruhiko Nakamura11Department of Chest Surgery, 2Department of Pediatric Surgery, 3Department of Pathology, St. Marianna University School of Medicine, Japan
Background. Typical pulmonary carcinoids rarely metastasize to the lymph nodes. We herein report a case of a resected typical pulmonary carcinoid with metastases to the mediastinal lymph nodes that released serum progastrin-releasing peptide (pro-GRP). Case. A 41-year-old female complaining of dizziness was diagnosed with Cushing syndrome based on the findings of endocrinologic examinations. A pulmonary nodular shadow was found on a chest X-ray. The maximum diameter of the shadow was 11 mm in the middle lobe. The patient was referred to our department under suspicion of an ectopic adrenocorticotropic hormone (ACTH)-producing tumor. The intraoperative pathological diagnosis of the resected tumor was a carcinoid. Right middle lobectomy with dissection of the lymph nodes was performed. The final diagnosis was a typical carcinoid with positive mediastinal lymph node (#4R) metastasis of pT1aN2M0, p-stage IIIA. The elevated ACTH and pro-GRP levels decreased to the normal range postoperatively. Adjuvant chemotherapy was administered, and the patient is currently disease-free at 20 months after undergoing surgery. Conclusions. Clinicians should therefore be aware of the possibility of lymph node metastases, even in cases of typical pulmonary carcinoids.
key words: Lung cancer, Carcinoid, Cushing syndrome, Adrenocorticotropic hormone, Progastrin-releasing peptide
Received: September 24, 2012
Accepted: May 24, 2013
JJLC 53 (3): 240-244, 2013
