Synchronous primary atypical pulmonary carcinoid and cecal adenocarcinoma: a case report

Abstract

Abstract. Pulmonary carcinoid tumors are a rare subgroup of neuroendocrine lung neoplasms, accounting for approximately 1-2% of all primary lung cancers. The occurrence of synchronous primary malignancies involving pulmonary carcinoid and colorectal adenocarcinoma is exceptionally uncommon. We report a 78-year-old woman initially diagnosed with an endobronchial atypical carcinoid tumor of the left lower lobe. After initial refusal of surgical treatment by the patient and following endoscopic management, a left lower lobectomy with systematic lymphadenectomy was performed. Histopathology confirmed a G2 atypical carcinoid (pT1cN0R0, stage I). One month later, the patient developed symptomatic anemia and abdominal pain. Colonoscopy revealed a stenosing adenocarcinoma of the cecum. A right hemicolectomy with en bloc resection of infiltrated adjacent structures was performed. Final staging demonstrated moderately differentiated adenocarcinoma (pT3N0R0, stage IIA). The postoperative course after both procedures was uneventful, and the patient was referred for adjuvant oncologic evaluation. Synchronous primary atypical pulmonary carcinoid and colorectal adenocarcinoma is rare. This case underscores the importance of distinguishing metastatic disease from synchronous independent primaries in elderly patients with newly diagnosed malignancies and highlights the role of multidisciplinary staged surgical management in achieving favorable outcomes.