Facial Flushing Due to Recurrent Bronchial Carcinoid

Ectopic Cushing and other paraneoplastic syndromes in thoracic neuroendocrine tumors

Overproduction of corticotropin by the pituitary gland or extrapituitary tumors leads to hypercortisolism or Cushing syndrome. Diagnosis of suspected Cushing syndrome involves 3 major steps: confirmation of hypercortisolism, differentiation between corticotropin-independent and corticotropin-dependent causes of Cushing syndrome, and distinction between pituitary and ectopic corticotropin production. A definitive diagnosis of ectopic corticotropin secretion requires stringent criteria, including reversal of the clinical picture after resection of the tumor and/or demonstration of corticotropin immunohistochemical staining within the tumor tissue.

Facial flushing due to multifocal tumorlets in the lung with bronchiectasis

Facial flushing attacks as a Carcinoid syndrome are quite a rare presentation in pulmonary tumorlets and bronchiectasis. We experienced a case in which a 43-year-old woman with bronchiectasis presented to our department with continuous facial flushing attacks for 3 years in the absence of bronchiectasis symptom. Computed tomographic scans revealed bronchiectasis of the left lower lobe and no tumor. A left lower lobectomy was performed, and multiple tumorlets were observed on microscopic examination among the bronchiectasis. Histologic and immunohistochemical examination revealed findings consistent with diffuse tumorlets and bronchiectasis in the lung.

Pediatric pulmonary tumors: primary and metastatic

Pediatric pulmonary tumors are rare. There is often a significant delay in diagnosis of pulmonary tumors secondary to their rarity and nonspecific presenting physiologic and radiographic findings. A high index of suspicion in pediatric patients with recurrent or persistent pulmonary symptoms is of paramount importance in diagnosing pulmonary tumors at an early stage. Malignant pulmonary tumors are more frequently diagnosed than benign lesions, with metastatic cancers being the most common. Complete surgical resection remains the basis of therapy for primary lesions, and its role in secondary cancers is becoming more established. Adjuvant therapies are frequently employed depending on the precise tumor involved. Mortality rates vary greatly depending on tumor location, stage, and type.