Lung carcinoid (neuroendocrine) tumour — a plain guide to a rare lung tumour

A lung carcinoid tumour, also called a pulmonary carcinoid or neuroendocrine lung tumour, is a growth that starts in the neuroendocrine cells lining the airways. These tumours are uncommon and belong to a separate family from the common lung cancers — non-small cell and small cell lung cancer. Many lung carcinoids grow slowly, and some are found by chance on a scan done for another reason. There are two main types, typical and atypical, which differ in how the cells look and behave under a microscope. Because carcinoids behave differently from common lung cancer, they are diagnosed and treated in their own way, and the outlook for many people is very different.

Yes — a lung carcinoid is a type of cancer, but it is generally a less aggressive one than the common lung cancers. Most are typical carcinoids, which tend to grow slowly and are less likely to spread. Atypical carcinoids are a little more active and need closer attention. Because they behave so differently from small cell lung cancer, which is the fastest-growing neuroendocrine type, it is not helpful to lump them together. A specialist can explain exactly where your tumour sits on this spectrum, based on your biopsy and scans, so you have a realistic picture rather than a frightening one drawn from general lung-cancer headlines.

The difference is decided by a pathologist examining the biopsy tissue. Typical carcinoids are the more common type; the cells divide slowly, and the tumour is less likely to spread beyond the lung. Atypical carcinoids are less common and show more cell activity under the microscope, so they can grow faster and are somewhat more likely to involve lymph nodes or spread. This distinction matters because it influences how closely the tumour is watched and which treatments are considered. Your pathology report will state which type you have, and a specialist can explain what that means for your treatment plan and follow-up.

Many lung carcinoids cause no symptoms and are found by chance. When symptoms do occur, they often come from a tumour in a central airway and can be mistaken for asthma or a chest infection. Common ones include a persistent cough, wheezing or noisy breathing, repeated chest infections in the same area, coughing up blood, and breathlessness. A small number of carcinoids release hormones and cause carcinoid syndrome — flushing, diarrhoea, or wheeze — though this is uncommon with lung carcinoids. None of these symptoms proves you have a carcinoid, as they have many ordinary causes, but a cough or coughing up blood lasting beyond three weeks should always be checked by a doctor.

Diagnosis follows a careful, stepwise path. A CT scan of the chest shows the size and position of any abnormal area. Because many carcinoids sit in the central airways, a bronchoscopy — a thin camera passed into the airways — can both see the tumour and take a biopsy. A biopsy is the only way to confirm a carcinoid and tell typical from atypical. A DOTATATE PET-CT scan is often used because carcinoid cells carry somatostatin receptors that the scan tracer binds to, helping pinpoint the tumour and check for spread. Blood tests and other supporting checks complete the picture. At CION, the findings are reviewed by a tumour board before any treatment decision.

A DOTATATE PET-CT is a specialised scan for neuroendocrine tumours, including lung carcinoids. It uses a tracer that binds to somatostatin receptors — proteins that are common on carcinoid cells. Because the tracer sticks to these cells, the scan can light up a carcinoid and show whether it has spread to other parts of the body, often more clearly than an ordinary CT or PET scan. This makes it valuable for planning treatment and for follow-up. The same receptor biology also explains why certain treatments, such as somatostatin analogues, can work for these tumours. You can read more on our DOTATATE PET-CT scan page.

Treatment depends on the type of carcinoid, where it sits, and whether it has spread. For carcinoids that have not spread, surgery to remove the tumour is usually the main treatment and often the one most likely to control it, with lung-sparing approaches used where possible. For tumours that have spread or cause hormone-related symptoms, somatostatin analogues can slow growth and ease symptoms. Receptor-targeted therapy such as PRRT, and sometimes radiation, may be considered in certain situations. For small, slow-growing tumours found by chance, careful monitoring is sometimes reasonable. Your tumour board agrees the plan together, and every option is explained with its costs before you decide.

The outlook for lung carcinoids is often more favourable than for the common lung cancers, particularly for typical carcinoids that have not spread and can be removed by surgery. Atypical carcinoids, and any that have spread, need closer treatment and follow-up. Outlook depends on the type, the stage, your overall health, and how the tumour responds to treatment, so general figures from the internet may not reflect your situation. The most reliable way to understand your own outlook is to discuss your specific reports with a specialist. At CION, your first 45-minute consultation is free and doctor-led, with time to talk through what your diagnosis means for you.