Endobronchial tumors in children: Institutional experience and literature review

Abstract

Background/purpose: Endobronchial tumors are rare in children and often misdiagnosed as benign conditions resulting in delayed definitive treatment. The authors reviewed their experience to highlight pertinent aspects of diagnosis and treatment.

Methods: A retrospective chart review was conducted of children with endobronchial tumors diagnosed between 1980 and 2002.

Results: Nine patients had endobronchial tumors (5 girls, 4 boys), with average age of 13 years (range, 8.5 to 15 years). There were 5 carcinoid tumors, 3 mucoepidermoid carcinomas, and one pseudotumor. Preoperative bronchoscopic biopsy confirmed the diagnosis in 6 patients, was inconclusive in one, and not done in 2. All except one (pseudotumor) underwent surgical resection. Laser ablation was performed in 2 cases with complete cure in one. All had an uneventful postoperative course except one patient in whom ipsilateral pneumonia developed. Long-term follow-up was obtained with clinical examination, pulmonary x-ray, abdominal ultrasound scan, chest computed tomography scan, and serum 5-HIAA in those with carcinoid tumor. Bronchoscopy was performed twice yearly for the first 2 years, then yearly. No evidence of local or distant recurrence was reported.

Conclusions: Endobronchial lesions should be considered in children with persistent pneumonia despite adequate treatment or with undiagnosed respiratory symptoms. Prognosis is excellent with surgical resection. Specific follow-up protocol is recommended.