Carinal carcinoid : endoscopic laser assisted mechanical resection

Carinal carcinoid : endoscopic laser assisted mechanical resection - Video Session This video demonstrates the technical details of endoscopic radical resection of endobronchial carcinoid by laser-assisted rigid bronchoscopy. A 35-year-old woman with a history of cough and asthma was referred to our Department for acute emophtoe. Chest CT scan disclosed a round well-defined mass occluding the right main bronchus; no lymph nodal involvement or tracheo-bronchial wall infiltration was evident. Flexible bronchoscopy confirmed that the right main bronchus was fully occluded by a floating lesion whose biopsy disclosed a typical carcinoid with a proliferation fraction of 2% and a proliferation index of 1 mytosis/10 high powered fields (HPF). Considering the low-grade biological features of the lesion, the absence of lymph nodal involvement or tracheo-bronchial wall infiltration, endoscopic laser-assisted mechanical resection was performed with radical intent. Intraoperative findings suggested an accomplished radical resection and biopsies performed by flexible bronchoscopy 30 days later excluded residual disease on the implant base. Main carina resection was then skipped and a strict follow-up program was started