[Bronchial adenoma]

Abstract

Twenty-four patients with bronchial adenoma seen over a 20-year period are reviewed. Follow-up data was available in all patients. They included 19 with carcinoid, 2 with adenoid-cystic carcinoma, and 3 with muco-epidermoid carcinoma. Recurrent pulmonary infection, cough and hemoptysis were the most common clinical manifestations. Surgical resection was performed in all but one patient, who was treated by irradiation; bronchoplastic and conservative resectional procedures were used in 5 patients with carcinoid adenoma. Carcinoid tumors are considered to be very slowly-growing malignant neoplasms that sometimes give rise to metastases to regional lymph nodes. Such metastases were present in only one patient. All patients are alive and well. Adenoid-cystic carcinoma is a more aggressive tumor with a tendency to recur. Much of the difficulty in its treatment is due to its close proximity to the bifurcation of the trachea. One patient was operated upon three times for local recurrences and ultimately died from respiratory failure after the third operation. The other patient received radiation therapy with cobalt and is well, without recurrence, 3 years after the treatment. The 3 muco-epidermoid carcinomas were histologically similar to such tumors of salivary glands but behaved clinically like highly malignant tumors, no patients surviving 8 months after resection. The term bronchial adenoma is a misnomer. The neoplasms grouped under this heading should be called carcinoid adenoma, adenoid-cystic carcinoma, and muco-epidermoid carcinoma and considered as separate entities, since the ultimate course and prognosis is definitely different.