Abstract
Primary bronchial mucoepidermoid carcinoma in the lung is relatively rare. It rarely presents with the highly malignant biological characteristic of bone marrow metastasis. We describe a case of this disease with bone marrow metastasis. A 56-year-old man with the primary manifestation of bone pain and bloodstained sputum had two abnormal shadows on the left inferior lobar bronchus and peripheral tissue of the lower lobe of the left lung, respectively. Computed tomography-guided percutaneous puncture biopsy and bone imaging confirmed the diagnosis of high-grade bronchial mucoepidermoid carcinoma with bone metastasis. However, the patient soon presented with progressive hemoglobin and platelet decline and severe multi-organ hemorrhage. Subsequently, we performed bone marrow aspiration and biopsy, which revealed malignant cells and necrosis. The patient deteriorated rapidly from the disease, and died on the 16th day of admission. We hope that this case report will increase awareness of the possibility of primary high-grade bronchial mucoepidermoid carcinoma metastasizing to the bone marrow, which might be a poor prognostic factor.
Highlights
Primary bronchial mucoepidermoid carcinoma, a lowmalignant potential tumor of bronchial gland origin, is relatively rare and comprises approximately 0.1% of all malignant lung tumors [1]
We report a case of unusually aggressive bronchial mucoepidermoid carcinoma with bone marrow metastasis with the aim of raising awareness of the malignant biological behavior of this tumor
Based on its histopathological features, we diagnosed the present lung tumor as primary high-grade bronchial mucoepidermoid carcinoma, which is relatively rare in the lung
Summary
A lowmalignant potential tumor of bronchial gland origin, is relatively rare and comprises approximately 0.1% of all malignant lung tumors [1]. Mucoepidermoid carcinomas rarely present highly malignant biological characteristics, especially bone marrow metastasis. Based on the clinical and auxiliary examination findings, the presumptive diagnosis was lung cancer with multiple bone metastases. On his third day in hospital, the patient underwent CT-guided percutaneous puncture biopsy of the lung and received palliative radiotherapy for the areas with. On the sixth day of admission, he presented with mild hemoptysis; routine blood examination revealed clearly decreased HGB and PLT, which were 6.2 g/dL and 56,000/mm, respectively. As we suspected bone marrow infiltration by the cancer cells, we stopped radiotherapy and suggested that he undergo bone marrow aspiration and biopsy Following rapid deterioration from the disease, he died on the 16th day of admission
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