WHEEZING: A WHISTLEBLOWER FOR PULMONARY CARCINOID

TOPIC: Lung Cancer TYPE: Medical Student/Resident Case Reports INTRODUCTION: Dyspnea and wheezing are the common complaints encountered in primary care setting. Primary physicians should keep diseases their minds while also keeping rare differential diagnosis. The incidence of pulmonary carcinoid is around 5 cases/100,000. Carcinoid tumors comprise 2% all lung tumors. (1) Hemoptysis cough most symptoms associated with carcinoid. We report a case patient who presented refractory wheezing. CASE PRESENTATION: A 36-year-old lady history asthma worsening dyspnea for past one month. She had no other complaints. was frequently using an albuterol inhaler; however, she benefit. Physical examination unremarkable except prescribed corticosteroid salmeterol inhaler. denied resolution despite inhalers On her follow-up visit, CXR performed, which remarkable left lower lobe mass. CT Chest showed 4x5 cm mass (fig 1). PET scan significant Gallium-68 dotatate uptake evident somatostatin-rich tumor 2). 24h urinary 5-hydroxyindoleacetic Acid (5-HIAA) unremarkable. Bronchoscopy demonstrated large occlusive bronchial biopsy typical underwent lobectomy mediastinal lymph node dissection. low-grade 3). Mediastinal nodes were negative any metastasis. uneventful stay at hospital discharged. visit. DISCUSSION: Pulmonary disease. Typical carcinoids more prevalent than atypical carcinoids. tumors, high-grade (2). hypothesize that our wheezing, due to effect tumor. Centrally located present hemoptysis, cough, recurrent respiratory tract infections peripherally mostly silent. diagnosed by bronchoscopy. Treatment primarily surgery (3). Surgical modalities include pneumonectomy, lobectomy, segmentectomy, wedge resection. Chemotherapy radiotherapy treatment choice CONCLUSIONS: Clinicians utilize imaging studies rule out obstructive lesion patients dyspnea. REFERENCE #1: Cardillo G, Sera F, Di Martino M, et al. Bronchial tumors: nodal status long-term survival after Ann Thorac Surg. 2004;77(5):1781-1785. doi:10.1016/j.athoracsur.2003.10.089 #2: Davila DG, Dunn WF, Tazelaar HD, Pairolero PC. Mayo Clin Proc. 1993;68(8):795-803. doi:10.1016/s0025-6196(12)60641-7 #3: Jeung MY, Gasser B, Gangi A, thorax: spectrum radiologic findings. Radiographics. 2002;22(2):351-365. doi:10.1148/radiographics.22.2.g02mr01351 DISCLOSURES: No relevant relationships Muhammad Aamir, source=Web Response Ali AKRAM, Ibrar Islam, Jeet Lund, Junaid mir, Ateeb Ur Rahman,