ABSTRACT
Bronchial carcinoid tumours are rare, slow-growing, malignant, Low-grade neuroendocrine tumours that arise from Enterochromaffin (Kulchitsky) cells and are usually detected typically as indolent and solitary tumours. Approximately 2% of all lung tumours are bronchial carcinoid tumours. Case presentation: The authors report a case of 55-years-old man who presented with a history of cough for 1 month and was initially diagnosed with a case of COVID-19. Then he was treated as a case of pneumonia as seen on high-resolution computed tomography. Later, contrast-enhanced computed tomography and bronchoscopy-guided biopsy were done which revealed a right lower lobe neuroendocrine tumour (carcinoid), which was successfully resected. Clinical discussion: The majority of typical carcinoids are located in the central airways leading to bronchial obstruction with recurrent pneumonia, chest pain, and wheezing. During the COVID-19 pandemic, lung cancer patients were at higher risk of being affected by COVID-19. This study emphasizes that early identification and differential diagnosis are extremely difficult in the absence of comprehensive study and workup as the clinical and imaging findings of COVID-19 may resemble lung cancer. Although hilar and mediastinal lymph nodes are the most common metastatic sites for typical carcinoids, most lymphadenopathies are caused by a reactive inflammatory reaction. Conclusion: Bronchial carcinoids are uncommon, malignant neuroendocrine tumours for which the only curative management is complete surgical resection. With full resection, the result of typical carcinoids with lymph node metastases is favourable.
ABSTRACT
Introduction and importance: Multisystem Inflammatory Syndrome in Children (MIS-C) is an uncommon condition that can present with a wide range of clinical features and complications. As it can be confused with various diseases, diagnosis is crucial as proper management can improve the patient's condition. Case presentation: 14-year male presented with fever, abdominal pain, and cough on September 2021. On examination, he was febrile with a distended abdomen and enlarged liver. Following investigations, abdominal tuberculosis was suspected but his condition improved with broad-spectrum antibiotics, intravenous immunoglobulins, and high-dose steroids. Clinical discussion: Any children with COVID 19 infection who have fever with multiple systems involved after ruling out other causes of infections should be suspected to have MIS-C. Diagnosis can be challenging as its clinical presentation mimics conditions like Kawasaki disease, ricketssial disease and acute appendicitis, etc. In high prevalence countries, with predominant gastrointestinal features, it can be confused with abdominal tuberculosis as well, hence, proper diagnosis is crucial. Conclusion: The course of MIS-C can be fatal where most children require intensive care units and early institution of immunomodulatory therapy for their recovery. Also, all pediatricians need to have a high degree of suspicion to diagnose MIS-C as it can be confused with different illnesses.