Video-Assisted Rigid Endoscopic Laser Ablation for Endobronchial Mucoepidermoid Carcinoma in Pediatrics Without Pulmonary Resections

Abstract

IntroductionMucoepidermoid carcinoma (MEC) is a rare malignancy of primary endobronchial lesions in children. Early diagnosis is crucial for the disease, but it is often misdiagnosed as asthma or lung infection. Chest computed tomography and bronchoscopy are the most important diagnostic tools. Surgical resection is the current treatment of choice for low-grade MEC. In the past, lobectomy, sleeve lobectomy, or segmental resections were the most standard surgeries. Endoscopic treatment was used for lung preservation and effectual removal of the lesions. MethodsA retrospective study of pediatric patients with primary endobronchial lesions who underwent rigid bronchoscopic laser ablation since 2010 was conducted. Pre-operative images, endoscopic pictures, post-operative images, histological analyses, and patients’ clinical conditions were recorded and illustrated. ResultsFour patients were enrolled. Three patients presented initially with cough or hemoptysis. The lesion sites were the bronchus of the left upper lobe, left lower lobe, left main bronchus, and trachea. All patients underwent bronchoscopic laser ablation for tumor excision without anatomical resection. No major surgical complications were encountered. All patients survived without recurrence after a mean postoperative follow-up of 4.5 years (3–6 years). ConclusionVideo-assisted rigid endoscopic laser ablation for pediatric low-grade endobronchial MEC is a feasible, effective, and safe method. Close follow-up is essential for lung preservation management. Evidence levelLevel IV. Type of studyCase series with no comparison group.