Bronchial carcinoid tumours: a study on clinicopathological features and role of octreotide scintigraphy

Several authors proposed the stage at diagnosis and some histopathological features as prognostic factors of bronchial carcinoids. However, since larg e tumour diameters or nodal metastases are frequently associated to aggress ive histology, their prognostic role is unclear. To investigate the relatio nships between the clinicopathological parameters at diagnosis and outcome, 21 patients were analysed. Overall 26% of the radically resected patients recurred. Recurrences and disease-specific mortality were related to atypic al histology and, only in cases with typical histology, to the presence of hilar or mediastinal lymph node metastases. These prognostic factors were v aluable independently of the size of the primary tumour, that was remarkabl y homogeneous, always less than 3 cm, thus not predictive of recurrence. Mo reover we evaluated the role of somatostatin receptor scintigraphy, a diagn ostic tool only preliminary studied in this field. Scintigraphy with In-111 -octreotide revealed the primary tumours at diagnosis (8/8), the increase i n tumour size in two unresected patients, and all the cases of recurrent or metastatic disease (5/11), sometimes before the appearance of symptoms. Th ese results suggest the usefulness of histology and nodal status as prognos tic factors in clinical practice. Somatostatin receptor scintigraphy turns out to be a powerful diagnostic tool, for an accurate staging and an early diagnosis of recurrence in bronchial carcinoids. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.