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Primary Pulmonary Carcinoid as a Potential Marker for Second Primary Malignancy
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A7352 - Primary Pulmonary Carcinoid as a Potential Marker for Second Primary Malignancy
Author Block: K. C. Alonso1, A. B. Chatterjee2; 1Pulmonary and Critical Care Medicine, Wake Forest University Baptist Medical Center, Winston-Salem, NC, United States, 2Pulmonary and Critical Care Medicine, Wake Forest University Baptist Medical Center, Winston Salem, NC, United States.
RATIONALE: Neuroendocrine tumors (NET) and development of a second primary malignancy (SPM) have a known association. Current, albeit limited information suggests a correlation with an equal distribution amongst different forms of NET. However, this relationship has yet to be fully characterized amongst these various types of NET. The primary goal of this study is to expound upon what is already known about the specific relationship between primary pulmonary carcinoids and development of a SPM.
METHODS: Retrospective chart review and analysis of all the primary pulmonary carcinoid patients in the Wake Forest Baptist Health system through 2016.
RESULTS: There were 119 patients with primary pulmonary carcinoid, 99 with typical carcinoid and 20 with atypical carcinoid. A total of 62 other malignancies were identified in 50 patients. Ten patients had two or more primary malignancies in addition to the carcinoid. Thirty-five of the patients with SPM were women (70%) and 15 were men (30%). Forty-six percent of the typical carcinoid patients and 80% of the atypical carcinoid patients were diagnosed with SPM. The most commonly diagnosed SPM in both groups was breast adenocarcinoma with 17 total (27%), 13 in the typical and 4 in the atypical carcinoid patients. The majority of patients were diagnosed with the SPM subsequent to the carcinoid diagnosis (52%). The remainder were diagnosed with the SPM prior to or at the same time as the carcinoid diagnosis (48%). Of the patients with SPM, 48% were non-smokers. Of those with two or more primary malignancies in addition to carcinoid, 60% were smokers.
CONCLUSIONS: Secondary malignancies in the setting of a primary pulmonary carcinoid occur at a non-insignificant frequency. The most common secondary malignancy seen in our population was breast cancer. The diagnosis of a secondary malignancy is not solely associated with atypical carcinoids, but also typical carcinoids. These data, with what has been described in other studies, should perhaps alter the management of patients with primary pulmonary carcinoid. Specific recommendations may include a change in surveillance and cancer screening practices in this special population of patients if a primary pulmonary carcinoid is diagnosed first, especially in women.
Author Block: K. C. Alonso1, A. B. Chatterjee2; 1Pulmonary and Critical Care Medicine, Wake Forest University Baptist Medical Center, Winston-Salem, NC, United States, 2Pulmonary and Critical Care Medicine, Wake Forest University Baptist Medical Center, Winston Salem, NC, United States.
RATIONALE: Neuroendocrine tumors (NET) and development of a second primary malignancy (SPM) have a known association. Current, albeit limited information suggests a correlation with an equal distribution amongst different forms of NET. However, this relationship has yet to be fully characterized amongst these various types of NET. The primary goal of this study is to expound upon what is already known about the specific relationship between primary pulmonary carcinoids and development of a SPM.
METHODS: Retrospective chart review and analysis of all the primary pulmonary carcinoid patients in the Wake Forest Baptist Health system through 2016.
RESULTS: There were 119 patients with primary pulmonary carcinoid, 99 with typical carcinoid and 20 with atypical carcinoid. A total of 62 other malignancies were identified in 50 patients. Ten patients had two or more primary malignancies in addition to the carcinoid. Thirty-five of the patients with SPM were women (70%) and 15 were men (30%). Forty-six percent of the typical carcinoid patients and 80% of the atypical carcinoid patients were diagnosed with SPM. The most commonly diagnosed SPM in both groups was breast adenocarcinoma with 17 total (27%), 13 in the typical and 4 in the atypical carcinoid patients. The majority of patients were diagnosed with the SPM subsequent to the carcinoid diagnosis (52%). The remainder were diagnosed with the SPM prior to or at the same time as the carcinoid diagnosis (48%). Of the patients with SPM, 48% were non-smokers. Of those with two or more primary malignancies in addition to carcinoid, 60% were smokers.
CONCLUSIONS: Secondary malignancies in the setting of a primary pulmonary carcinoid occur at a non-insignificant frequency. The most common secondary malignancy seen in our population was breast cancer. The diagnosis of a secondary malignancy is not solely associated with atypical carcinoids, but also typical carcinoids. These data, with what has been described in other studies, should perhaps alter the management of patients with primary pulmonary carcinoid. Specific recommendations may include a change in surveillance and cancer screening practices in this special population of patients if a primary pulmonary carcinoid is diagnosed first, especially in women.
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