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Presence of Multiple Carcinoid Tumorlets in Lung Linked to Good Survival

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Presence of Multiple Carcinoid Tumorlets in Lung Linked to Good Survival


NEW YORK JUL 12, 2007 (Reuters Health) - The appearance of multiple carcinoid tumors -- or "tumorlets" -- on lung specimens is associated with "excellent" long-term survival and usually only mild airflow limitation, investigators report in the June issue of Chest.


Dr. Marie-Christine Aubry and colleagues at the Mayo Clinic in Rochester, Minnesota, systematically analyzed the significance of multiple carcinoid tumors or tumorlets in a series of 294 patients being treated at the Mayo Clinic between 1987 and 2000.


There were 28 patients with two or more tumors or tumorlets, and 26 of the 28 were women. Mean age was 65 years. Mean follow-up was 66 months.


Seventeen patients had multiple nodules. Nine of the 17 had stable disease with no growth in residual small indeterminate nodules.


Nearly half of patients with multiple nodules had respiratory problems. Two had Cushing's syndrome.


Ten patients (58.8%) had suspected pulmonary metastases, of whom seven had a history of cancer. Three patients had intrathoracic lymph node metastases, none of which recurred or further metastasized. One patient had a carcinoid tumor that was subsequently removed eight years later.


"Our findings suggest that multiple tumorlets and/or neuroendocrine cell hyperplasia may be associated with mild airflow limitation, but moderate-to-severe disease is uncommon," Dr. Aubrey and colleagues report.


There were no deaths in this series of patients. "Multiple tumorlets are associated with a generally good prognosis regardless of the clinical setting," the investigators note. "Most patients have persistent but stable disease without specific adjuvant therapy."


"Physiologically significant diffuse lung disease is uncommon, and most patients can be managed with observation or treatment appropriate to the underlying condition," they add.




* Chest 2007;131:1635-1643.

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