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AN UNEXPECTED FINDING OF PERSISTENT RIGHT LUNG COLLAPSE; CHILDHOOD ENDOBRONCHIAL TUMOUR: A CASE REPORT

Background and Aims: IntroductionChildhood endobronchial tumour is a rare condition in which patient usually presents with common respiratory symptoms like chronic cough, recurrent wheeze or lung collapse. Methods: CaseA 6-year-old girl was referred to our unit for persistent right lung collapse. She presented with history of cough and exertion dyspnea for 2 months. She was treated as necrotizing pneumonia and after 3 weeks of antibiotics; she had minimal clinical improvement and chest X-ray showed persistent right lung collapse. Examination showed she was tachypnoeic with reduced chest expansion and breath sounds on the right lung. Otherwise no crepitation or rhonchi was heard. InvestigationsShe was investigated extensively, including pulmonary tuberculosis and it was negative. Ultrasound thorax and CECT thorax showed collapsed consolidation consistent with necrotizing pneumonia and nodular like echogenic lesion in a consolidated lung parenchyma. Bronchoscopy revealed intraluminal vascularized mass at right main bronchus causing almost complete obstruction. Results: Managements -Excision biopsy was done with intraoperative finding of large vascularized mass from right main bronchus extending to the right upper lobe with multiple irregular nodules. Histopathology reported as Large Cell Neuroendocrine Carcinoma. In view of no standard guideline of chemotherapy in this type of carcinoma, she was treated as rhabdomyosarcoma-like tumour with vincristine, ifosfomide, doxorubicin and actinomycin. She underwent right thoracotomy and gross tumour excision after 2 cycles of chemotherapy. The tumour was excised as much as possible however residual tumour was still seen encircling the trachea, hoping that it will shrink further with subsequent cycle of chemotherapy. Conclusion: Large Cell Neuroendocrine Carcinoma is a rare primary endobronchial tumour and no standard therapy yet known to treat the condition.