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Abstract Background Pulmonary carcinoids are rare neuroendocrine tumors accounting for less than 1% of all lung cancers. They are classified into two subcategories; typical and atypical carcinoids with the latter tending to grow faster. Historically, open thoracotomy was the standard approach for pulmonary resection. However, in the recent years, video-assisted thoracoscopy has gained popularity and become the preferred technique for resectioning pulmonary carcinoids. This report details the diagnosis and management of a pleural carcinoid tumor in a patient with recurrent unilateral pleural effusion. Case presentation A 77-year-old African male with a history of hypertension and heart failure with reduced ejection presented with a 6-month history of an irritating non-productive cough, occasional productive episodes and exertional dyspnea but no history of hemoptysis, chest pain, orthopnea, evening fevers, or significant weight loss. Despite multiple interventions, including tube drainage and antituberculosis medications, symptoms persisted. A chest X-ray was performed and it revealed a homogeneous opacity on the left, and a computed tomography scan showed mild pleural thickening especially at the bases. Video-assisted thoracoscopy was performed revealing thickened pleural and biopsies confirmed a diagnosis of malignant carcinoid tumor. The patient underwent successful pleurodesis, resulting in significant improvement. Conclusion This case highlights the pivotal role of video-assisted thoracoscopy in diagnosing and managing rare cases such as pulmonary carcinoids when less invasive methods such as thoracentesis fail.

Abstract Background The abscopal effect was described as early as the 1950s, when untreated tumors demonstrated a response after radiation therapy was delivered to an untreated, distant site. The mechanisms underlying this global response to otherwise localized therapy remain unknown, though there is increasing evidence that increased antigen expression following ablative radiotherapy may play a role. Case presentation We report a case of a 69-year-old African American woman with a history of metastatic typical pulmonary carcinoid with multiple lung nodules who had a significant decrease in size of an untreated left upper lobe nodule after stereotactic body radiation therapy to an oligoprogressive left lower lobe lesion. Conclusions To our knowledge, this report describes the first case of an abscopal effect in a typical pulmonary carcinoid. Further research is needed regarding the mechanisms responsible for this finding and the role of combining radiation therapy and cancer immunotherapy in patients with pulmonary carcinoid tumors.

Abstract Background The response to temozolomide (TMZ) treatment in small-cell lung cancer (SCLC) correlated with O(6)-methylguanine -DNA methyltransferase (MGMT) promoter methylation. 1p/19q co-deletion within oligodendroglioma is a responsive predictor for TMZ. Currently, the status of MGMT promoter methylation and 1p/19q co-deletion in pulmonary carcinoid (PC) and large-cell neuroendocrine carcinoma (LCNEC) is not reported. Methods Nine PC [two atypical carcinoids (AC), seven typical carcinoids (TC)] and six LCNEC patients were collected retrospectively. The pyrosequencing and fluorescence in situ hybridization were used to detect the MGMT promoter methylation and 1p/19q co-deletion in surgically resected specimens. Kaplan–Meier analysis was used to assess the rate of disease-free survival (DFS). Results MGMT promoter methylation was found in two (2/6, 15.3%) LCNEC patients but not in any PC patients. Three (3/6, 50%) 1p and two (2/6, 33.3%) 19q single deletions were found in LCNEC patients. One 1p single deletion was found in AC patients. One (1/7, 14.3%) 1p and two (2/7, 28.6%) 19q single deletions were found in TC patients. After a median follow-up of 38 months, three LCNEC patients developed distant metastasis and one patient died of LCNEC disease. The DFS of PC patients was much longer than LCNEC patients (χ 2 = 7.565, P = 0.006). Conclusions MGMT promoter methylation and 1p/19q co-deletion might not be the ideal biomarkers for TMZ treatment in TC/AC patients. Thus, the detection of MGMT promoter methylation and whether it can be used as a medication for TMZ in LCNEC patients necessitates investigation. Furthermore, 1p deletion could be a negative prognostic factor for LCNEC patients.