İnisyal bronkoskopik tedavi uygulanan tipik karsinoid tümör olgusu

Akciğerdeki tipik karsinoid tümörlerin malignite potansiyeli düşüktür ve daha az invazif yöntemlerle tedavilerinden bahsedilebilmektedir. İntraluminal bronşiyal tipik karsinoidli olgularda bronkoskopik tedaviler acil cerrahi girişimlerin alternatifidir. Cerrahi öncesi bronkoskopik tedaviler, hastanın klinik durumunu düzeltmek ve parankim koruyucu rezeksiyonlara olanak sağlamak için uygulanmaktadır. Cerrahi öncesi inisyal bronkoskopik tedavi uygulanmasının cerrahi tedavi sonuçlarına olumsuz bir etkisi yoktur. Bu makalede argon plazma koagülasyonu ile inisyal bronkoskopik tedavi uygulanan intraluminal bronşiyal tipik karsinoidli bir olgu sunulmaktadır. Kırk sekiz yaşında erkek olgu üç aydır devam eden prodüktif öksürük ve balgam çıkarmaktan yakınmaktaydı. Bronkoskopide endobronşiyal vaskülarize tümor saptandı. Histopatolojisi tipik karsinoid olarak raporlandı. Hastaya birkaç seans endobronşiyal argon plazma koagülasyonu ile tedavi uygulandı. Tedaviler sonrası şikayetleri düzeldi ama 4. ay kontrolünde nüks saptandı. Bunun üzerine parankim koruyucu cerrahiyle başarıyla tedavi edildi.

Initial Bronchoscopic therapy for typical bronchial carcinoid: Case report

Malignancy of carcinoid tumors of the lung are potentially low and therefore less invasive treatments may be considered. Bronchoscopic treatment is an alternative to immediate surgical resection in patients with intraluminal bronchial typical carcinoids. Initial bronchoscopic treatment is given to improve presurgical condition, and to enable less extensive parenchymal resection. Implementation of initial bronchoscopic treatment has no negative impact on surgical treatment outcome. We here in report a case of intraluminal bronchial typical carcinoid removed by argon plasma coagulation by initial bronchoscopic approach. The case was a 48-year-old man, suffering from productive cough and sputum for three months. Bronchoscopic examination revealed endobronchial vascularized tumors. Based on histopathological findings, we diagnosed typical carcinoids. The patient underwent argon plasma coagulation treatment by bronchoscopic approach several times. After a series of treatments, his symptoms improved but recurrence was found at the 4th month of followup. Then the patient was treated successfully by means of parenchyma-saving procedure.

Kaynakça

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