Abstract Introduction Pulmonary carcinoid tumors are uncommon neuroendocrine neoplasms, accounting for 1-2% of all lung malignancies. They are classified as typical or atypical based on histologic features. Typical carcinoids are well-differentiated and indolent, while atypical carcinoids show higher mitotic activity and potential for recurrence. These tumors often occur in non-smokers and may be detected incidentally. We present a case of a never-smoker whose evaluation for a viral illness led to the incidental discovery of an atypical carcinoid tumor. Case Description A 50-year-old female, never-smoker, with no significant past medical or exposure history initially presented to urgent care with symptoms of a viral illness. A chest X-ray obtained at that visit revealed left-sided pneumonia and an incidental pulmonary nodule. Subsequent computed tomography (CT) imaging demonstrated a 1.5 cm mass in the right upper lobe. To further characterize the lesion, a positron emission tomography (PET) scan was performed, revealing a standardized uptake value (SUV) of 2.1. Given the indeterminate size and increased metabolic activity, the patient underwent bronchoscopy, which did not reveal any endobronchial lesions.She was then admitted for image-guided (IR) biopsy, which confirmed a neuroendocrine neoplasm consistent with an atypical carcinoid tumor. After evaluation by thoracic surgery, she underwent a successful robotic-assisted right upper lobectomy. Discussion This case highlights the incidental detection of a pulmonary atypical carcinoid in a never-smoker. Neuroendocrine tumors (NETs) of the lung are rare, comprising a small subset of pulmonary neoplasms, and may secrete amines and peptides that lead to carcinoid syndrome in a minority of patients. However, many patients remain asymptomatic, and NETs are often discovered incidentally.Subtle imaging findings—such as mild PET uptake (SUV 2.1)—do not exclude malignancy and may be misleading. Definitive diagnosis requires histopathologic confirmation. Surgical resection, such as lobectomy with lymphadenectomy, remains the cornerstone of treatment and can provide excellent outcomes and long-term survival when complete removal is achieved. In selected cases, sublobar resection may be considered, particularly when preserving lung function is crucial. Continued surveillance is recommended due to the potential for late recurrence.Studies have reported five-year survival rates approaching 100% for typical carcinoids, which are significantly higher than those for atypical carcinoids. Therefore, diligent long-term follow-up is imperative to detect potential late recurrences. This abstract is funded by: none
Dwivedi et al. (Fri,) studied this question.