Biopsy of the lesion in the previous question is reported as “bronchial carcinoid with no signs of atypia.” Which of the follow is/are true?

a. Sleeve resection of the bronchus would be appropriate

c. Associated carcinoid syndrome is very unlikely

d. If carcinoid syndrome were found in a tumor this size, hepatic metastases would be likely

In the absence of atypia, carcinoids are only locally malignant and can be managed by limited lung and/or bronchial resection. Therefore, a sleeve resection of the bronchus preserving distal lung would be appropriate. Lymph node sampling at the time of resection, however, is advisable to ensure that a complete resection has been performed. The carcinoid syndrome is rarely found except in the presence of a large primary tumor or hepatic metastases. When the carcinoid syndrome does occur, it is left-sided cardiac valves that are affected rather than right, which one would expect with gastrointestinalcarcinoids.