Neumonectomía R1 por carcinoide atípico, ¿qué sigue?

Atypical endobronchial carcinomas have a worst prognosis than the typical subtype; the best treatment is total surgical resection depending on the affected area. We present a 47-year-old male with a tobacco index of 9 and dyslipidemia, with a history of intermittent fever, cough with hyaline sputum, left scapular pain and 5 Kg weight loss in the past six months. Imaging studies revealed an endobronchial tumor in left main bronchi at less than 2 cm from the cari- na occluding 100% of its lumen; a pneumonectomy was performed with a pericardial adipose tissue flap placed on the bronchial stump. Pathology reported an R1 resection. Patient con - tinues with adequate evolution and without macroscopic evidence of recurrence. National Comprehensive Cancer Network (NCCN) guidelines suggest a redo-surgery, nevertheless in a case as ours; consideration has to be made for a conservative approach.