Bronchial Adenomas Bronchial adenomas (80% are central) are slow-growing endobronchial lesions; they represent 50% of all benign pulmonary neoplasms. About 80–90% are carcinoids, 10–15% are adenocystic tumors (or cylindromas), and 2–3% are mucoepidermoid tumors. Adenomas present in patients 15–60 years old (average age 45) as endobronchial lesions and are often symptomatic for several years. Patients may have a chronic cough, recurrent hemoptysis, or obstruction with atelectasis, lobar collapse, or pneumonitis and abscess formation. Bronchial adenomas of all types, because of their endobronchial and often central location, are usually visible by fiberoptic bronchoscopy. Because they are hypervascular, they can bleed profusely. | Chapter 085. Neoplasms of the Lung Part 18 Bronchial Adenomas Bronchial adenomas 80 are central are slow-growing endobronchial lesions they represent 50 of all benign pulmonary neoplasms. About 80-90 are carcinoids 10-15 are adenocystic tumors or cylindromas and 2-3 are mucoepidermoid tumors. Adenomas present in patients 15-60 years old average age 45 as endobronchial lesions and are often symptomatic for several years. Patients may have a chronic cough recurrent hemoptysis or obstruction with atelectasis lobar collapse or pneumonitis and abscess formation. Bronchial adenomas of all types because of their endobronchial and often central location are usually visible by fiberoptic bronchoscopy. Because they are hypervascular they can bleed profusely after bronchoscopic biopsy and this problem should be anticipated. Bronchial adenomas must be considered as potentially malignant thus requiring removal for symptom relief and because they can be locally invasive or recurrent potentially can metastasize and may produce paraneoplastic syndromes. Surgical excision is the primary treatment for all types of bronchial adenomas. The extent of surgery is determined at operation and should be as conservative as possible. Often bronchotomy with local excision sleeve resection segmental resection or lobectomy is sufficient. Five-year survival rate after surgical resection is 95 decreasing to 70 if regional nodes are involved. The treatment of metastatic pulmonary carcinoids is unclear because they can either be indolent or behave more like SCLC Chap. 344 . Assessment of the tempo and histology of the disease in the individual patient is necessary to determine if and when chemotherapy or radiotherapy is indicated. Carcinoid and Other Neuroendocrine Lung Tumors Neuroendocrine lung tumors represent a spectrum of pathologic entities including typical carcinoid atypical carcinoid and large cell neuroendocrine cancer as well as SCLC. SCLC and large cell neuroendocrine cancer are .
