EPITHELIAL MYOEPITHELIAL CARCINOMA: A RARE CAUSE OF ENDOBRONCHIAL OBSTRUCTION

Abstract

SESSION TITLE: Monday Fellow Case Report Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM INTRODUCTION: Endobronchial tumors have been reported in numerous benign and malignant conditions. Epithelial myoepithelial carcinoma is a rare malignant cause of endobronchial obstruction for which guidelines for management are lacking. CASE PRESENTATION: A 74 y/o female presented with a complaints of wheezing and hemoptysis. A CT chest revealed an 8 mm obstructing lesion in the distal left main stem bronchus. A bronchoscopy with endobronchial biopsy was performed by the patient's general pulmonologist which showed a low grade salivary gland tumor. She was then referred to Interventional Pulmonology for further removal and management of the tumor. Rigid and flexible bronchoscopy were performed with debridement of the tumor using the bevel of the rigid bronchoscope followed by mechanical debridement with forceps. Due to residual tumor which appeared embedded within the bronchial wall, laser debridement was performed using a 600 nm diode laser fiber at 14W, pulse 1, 0.7s. Additional endobronchial biopsy specimens were consistent with an epithelial myoepithelial carcinoma. The case was reviewed by our institution's Tumor Board with recommendations for additional imaging including CT head and neck which were negative for further evidence of malignancy. Symptoms resolved following resection of the tumor. DISCUSSION: Epithelial myoepithelial carcinoma is a rare malignant tumor seen most frequently in the salivary glands. There are a small number of case reports of primary lung tumors consistent with the same pathology as these salivary gland tumors which are believed to originate from the submucosal bronchial glands. As additional imaging in our patient was negative for malignancy, this is presumed to be a rare, primary lung malignancy. Following local resection and laser debridement, our patient will be monitored closely with surveillance bronchoscopy and imaging for evidence of recurrence. CONCLUSIONS: Given the rarity of epithelial myoepithelial carcinoma, long term follow up is required in order to provide improved recommendations regarding both management and prognosis. Reference #1: Latife Doganay, Selcuk Bilgi, Asli Ozdil, Yener Yoruk, Semsi Altaner, and Kemal Kutlu (2003) Epithelial-Myoepithelial Carcinoma of the Lung. Archives of Pathology & Laboratory Medicine: April 2003, Vol. 127, No. 4, pp. e177-e180. DISCLOSURES: No relevant relationships by Sara Greenhill, source=Web Response No relevant relationships by Jessica Johnson, source=Web Response