Pulmonary Carcinoid Tumors (Lung Carcinoids): Current Concepts in Diagnosis and Management

Pulmonary carcinoid tumors are rare lung neuroendocrine neoplasms with diverse clinical behavior, ranging from indolent localized disease to metastatic progression. Diagnosis relies on histopathology but may be supplemented by immunohistochemical markers such as Ki-67. Recent molecular and multi-omic studies reveal substantial heterogeneity, identifying molecularly defined subgroups and highly proliferative carcinoids with aggressive behavior. Management includes surgical resection for localized disease and systemic therapies for advanced cases, such as somatostatin analogs, targeted agents, peptide receptor radionuclide therapy, and chemotherapy. While emerging molecular classifications and biomarker-driven strategies hold significant promise, current management of advanced pulmonary carcinoids relies heavily on extrapolated data from mixed neuroendocrine cohorts, underscoring the urgent need for prospective thoracic-dedicated trials to validate these paradigms in clinical practice. Emerging biomarker-driven trial designs and integrated precision medicine approaches offer opportunities to optimize therapy and improve outcomes in this rare tumor type.