Tumor neuroendocrino (carcinoide) pulmonar en pediatría con coinfección por Mycobacterium tuberculosis: reporte de caso

A Typical bronchial carcinoid tumor is a rare malignant neoplasm of neuroendocrine origin. The clinical presentation is usually nonspecific, and the diagnosis is made by fibrobronchoscopy, histopathologic confirmation, and immunohistochemistry. The treatment of choice is complete surgical resection with preservation of lung tissue, with a 20-year survival rate of 94%. This clinical case stands out due to the infrequency and nonspecific presentation of a bronchial carcinoid tumor in adolescence, highlighting the importance of recognizing it as an alternative diagnosis in the face of persistent respiratory symptoms without improvement—a male adolescent with a history of recurrent Pneumonia and persistent atelectasis in the right lung base. Bronchoscopy showed a 100% occlusive endobronchial mass, with pathology and immunohistochemistry confirming the diagnosis of a typical carcinoid tumor. After staging studies and regular biochemical markers, it was decided to perform surgery for curative purposes. Resection of the right middle and lower lobes and of the tumor lesion, bronchoplasty, and mediastinal lymph node drainage were successfully performed. However, the patient presented a stationary evolution due to Pneumonia complicated with pleural effusion and pneumothorax that required antibiotic management for 21 days and closed thoracostomy plus thoracoscopy with decortication. Metastatic tumor involvement was ruled out with octreotide scintigraphy and infectious profile studies were extended, which confirmed infection by Mycobacterium tuberculosis. The importance of the diagnostic suspicion of a neoplasm in the management of an adolescent with recurrent Pneumonia or atelectasis (in the exact location), which is uncommon, where bronchoscopy and computed tomography (CT) could guide the diagnosis.