Bronchial Mucoepidermoid Carcinoma Research Articles

Endoscopic resection of bronchial mucoepidermoid carcinoma in a young adult man: A case report and review of literature

Primary tracheobronchial mucoepidermoid carcinoma (MEC), derived from salivary mucus glands, is an uncommon neoplasm in adults. At present, surgery is still the preferred treatment for adult bronchial MEC, although it may cause significant trauma and loss of lung function. Here, we report a patient with endobronchial MEC who received the interventional bronchoscopic therapy to remove the neoplasm and no recurrence occurred during follow-up. A 28-year-old man was admitted to our unit with mild hemoptysis for 3 d. Physical examination did not show any abnormal signs, and the serological indexes were all in the normal range. Chest computed tomography (CT) indicated an intraluminal nodule in the bronchus intermedius with homogeneous density and a well-defined margin. Upon fiberoptic bronchoscopy, an endobronchial pedunculated polypoid was discovered without submucosal involvement. As the neoplasm was confined to the bronchus, interventional bronchoscopy was performed to remove the mass by high-frequency electric knife and laser resection. Tissue was sampled and histopathological examination confirmed the diagnosis of low-grade MEC. As the proliferation index was low, no further treatment was given. During 2 years of follow-up, the patient's condition was good and no relapse was discovered under fluorescence bronchoscopy or CT scan. Interventional bronchoscopy can be considered for treatment of low-grade bronchial MEC, with few complications and preserved lung function.

Clinical significance of interventional therapeutic bronchoscopy combined with bronchial arterial embolization in the treatment of hypervascular primary airway tumors in children.

ABSTRACTImportancePediatric hypervascular primary airway tumors are progressive, fatal lesions with a low incidence, and the disease is often more serious than that in adults.ObjectiveTo evaluate the clinical efficacy and safety of interventional therapeutic bronchoscopy combined with conservative treatment and bronchial arterial embolization in children with primary airway tumors.MethodsWe retrospectively analyzed the clinical data of four pediatric patients with hypervascular primary airway tumor between 2017 and 2019 at Beijing Children’s Hospital.ResultsTwo patients were low‐grade bronchial mucoepidermoid carcinoma, one patient was pleomorphic adenoma, and one was bronchial leiomyoma. Interventional therapeutic bronchoscopy combined with bronchial arterial embolization was used for treatment (all four patients received general anesthesia). The tumors were safely resected in all patients via interventional bronchoscopy. There were no severe complications related to the procedures. All patients were followed up for 5–12 months, and one low‐grade bronchial mucoepidermoid carcinoma recurred.InterpretationInterventional therapeutic bronchoscopy combined with bronchial arterial embolization appears to be a safe and efficient therapeutic method associated with less trauma and fewer complications, including no serious adverse events, in children with hypervascular primary airway tumors without bronchus wall infiltration.

Clinical features and interventional bronchoscopic treatment of primary airway tumor in 8 children

Objective: To summarize the clinical manifestations and to evaluate the feasibility of therapeutic bronchoscopy in pediatric primary airway tumors. Methods: The clinical data of 8 children presented with airway tumors in Beijing Children's Hospital from November 2016 to March 2018 were retrospectively analyzed. Descriptive analysis was used to summarize the outcome and prognosis of these children after interventional bronchoscopy. Results: Among the 8 children, 5 were male and 3 were female, aged from 4 years and 8 months to 9 years and 2 months. The main clinical manifestations were cough and wheezing in 6 cases, hemoptysis in 3 cases and recurrent pulmonary infection in 2 cases, and none of them had lymph node metastasis and extra-pulmonary metastasis. All 8 children underwent bronchoscopic resection of the tumors, and the 4 children with blood-rich tumors had bronchial artery embolization at the blood supply site before the resection. No major bleeding or pneumothorax occurred during or after the operation. Four cases had low grade malignant bronchial mucoepidermoid carcinoma, 2 had inflammatory myofibroblastoma, and the rest two had pleomorphic adenoma and bronchial smooth muscle spindle cell tumor. Postoperative follow-up lasted 2 to 4 years, and 3 had tumor recured. Among the 3 cases, 2 had inflammatory myofibroblastoma who underwent surgical resection of the lesion and combined chemotherapy, respectively; and one had mucoepidermoid carcinoma who was under follow-up after interventional cryotherapy. Conclusions: The clinical manifestations of primary airway tumors in children are atypical. The main clinical manifestations are dry cough, wheezing, recurrent pulmonary infection and hemoptysis. Interventional bronchoscopy is a feasible choice for the treatment of pediatric airway tumors.

Bronchial Mucoepidermoid Carcinoma in a Young Male

Bronchial Mucoepidermoid Carcinoma in a Young Male

A Rare Case of Bronchial Mucoepidermoid Carcinoma Treated by Endobronchial Electrocautery Using a Polypectomy Snare

A Rare Case of Bronchial Mucoepidermoid Carcinoma Treated by Endobronchial Electrocautery Using a Polypectomy Snare

Hyalinizing clear cell carcinoma of the bronchial glands: presentation of three cases and pathological comparisons with salivary gland counterparts and bronchial mucoepidermoid carcinomas

AbstractHyalinizing clear cell carcinoma of the bronchial glands is a very rare tumor. Since only five reports describing six tumors have been published to date, only a little is known about specific histologic findings and clinical features. Because of its rarity, hyalinizing clear cell carcinoma has not been described in the latest WHO classification of pulmonary tumors yet. Here we present three cases of bronchial hyalinizing clear cell carcinomas, confirmed by both fluorescence in situ hybridization (FISH) and RT-PCR, focusing on histologic and immunohistochemical characteristics in a comparison with three cases of salivary gland origin. In addition, we compared immunohistochemical features with bronchial mucoepidermoid carcinoma, a lesion that needs to be taken into account in differential diagnosis of hyalinizing clear cell carcinoma. All our bronchial hyalinizing clear cell carcinoma cases were surgically resected. Histologically, tumor cells showed clear to eosinophilic cytoplasm with hyalinizing stroma in various proportions, resembling those of salivary gland origin. Immunohistochemically, tumor cells were positive for CK7, CK5/6, p40, p63, and ATF1, while they were negative for TTF1, Napsin A, HMB45, and SOX10. The CK5/6 staining pattern varied in mucoepidermoid carcinomas, while that of hyalinizing clear cell carcinoma was uniformly positive. FISH revealed EWSR1-ATF1 fusion, and RT-PCR with sequencing confirmed specificity of the chimeric gene for hyalinizing clear cell carcinoma. Clinically, bronchial hyalinizing clear cell carcinoma was characterized by occurrence in the fourth to sixth decades, no link with smoking history, and a predilection for the right lung, in line with previous reports. In summary, our study confirmed that the bronchial hyalinizing clear cell carcinoma is a histologically and genetically identical tumor to that of salivary gland origin, and that gene rearrangement analysis can play a critical role in distinction from mucoepidermoid carcinoma.

Bronchial Mucoepidermoid Carcinoma in a 14-year-old Patient

A bronchial mucoepidermoid carcinoma is a rare malignant tumour. It usually appears in young subjects and most often involves the salivary glands. We report the case of a 14-year-old patient who presented with a pulmonary mucoepidermoid carcinoma that was discovered during the evaluation of a case presenting with recurrent pneumopathies.

Bronchial Mucoepidermoid Carcinoma Successfully Treated with Radiation Therapy: A Case Report

A 69-year-old female presented with dyspnea and dysphagia. Chest computed tomography showed a middle mediastinum tumor compressing the trachea. Biopsy showed mucoepidermoid carcinoma (MEC). A tracheal stent was placed to keep the airway patency and radiation therapy (RT) was started. However, the patient’s respiratory status worsened and she was intubated. The intratracheal tumor was reduced using argon plasma coagulation. After restarting RT of 49 Gy, the tumor shrank, allowing the patient to be weaned from ventilatory support. Although MEC is considered RT-resistant, it was beneficial in our case, suggesting that RT is a treatment option for unresectable bronchial MEC.

Intra bronchial mucoepidermoid carcinoma in an 8 year old girl: A case report of rare tumor with review of literature

Abstract Intra bronchial and intra tracheal tumors are very rare in pediatric age group. Most of the literature clubs primary pulmonary tumors with these; hence actual incidences are not well defined. Amongst this mucoepidermoid carcinoma (MEC), whether low or high-grade account for only 0.1–0.5% of lung carcinomas. We report such a rare case of an eight year old girl presenting with history of recurrent lower respiratory tract infections with respiratory distress. CT scan of chest was suggestive of a mediastinal mass. She underwent rigid bronchoscopic biopsy, histopathology showed it to be mucus gland adenoma. She underwent right thoracotomy with complete excision of mass along with right lower lobectomy. Histopathology reported it to be a low-grade MEC with clear margins. She did not require any chemotherapy or radiotherapy and has no recurrence at 1-year follow up.

Application of bronchoscope in diagnosis and treatment of bronchial mucoepidermoid carcinoma in children

Objective To explore the application of bronchoscope in diagnosis and treatment of bronchial mucoepidermoid carcinoma in children. Methods The clinical data of 4 cases of bronchial mucoepidermoid carcinoma treated in Department of Interventional Pulmonology, Beijing Children's Hospital Affiliated to Capital Medical University from April 2013 to June 2015, were retrospectively analyzed, and their clinical manifestations, chest computed tomography(CT), bronchoscopic manifestations were analyzed. Results Among the 4 cases of bronchial mucoepidermoid carcinoma, 3 cases were low-grade bronchial mucoepidermoid carcinoma, and 1 case was intermediate grade malignant. Onset of clinical manifestations occurred from the ages of 4 years and 11 months old to 10 years and 9 months old.All patients had no characteristic clinical manifestations, only 2 cases had hemoptysis, while the main symptoms were cough, wheezing, and exercise tolerance decreased in 4 the patients, and they were initially misdiagnosed as pneumonia, asthma or bronchial foreign body.Chest CT prompted that there was circular mass in respiratory tract, the lesions located in left main bronchus in 2 patients, in right bronchus intermedius in 1 patient, and in right middle bronchus in 1 case, and atelectases or emphysema occurred in bronchus.The biopsy by bronchoscope under general anesthesia was performed for more enough specimen in all the 4 patients.The lesions were completely removed in 3 patients by interventional bronchoscopy, and 1 patient by lobectomy. Conclusions The children with bronchial mucoepidermoid carcinoma were presented with cough and wheezing without specific manifestations. Biopsy by bronchoscope is a good choice for the diagnosis of bronchial mucoepidermoid carcinoma. Bronchoscopic intervention was effective in the treatment of non-operative carcinoma. Key words: Mucoepidermoid carcinoma; Bronchus; Child; Bronchoscope

Efficacy of bronchoscopic therapies for bronchial mucoepidermoid carcinoma in children: results from six patients.

Bronchial mucoepidermoid carcinoma is a rare disease in children, and lobectomy is traditionally considered as a first-line treatment. As the tumor is characterized by intraluminal growth, low malignancy and superficial infiltration of bronchial walls, bronchoscopic interventional therapy may provide an alternative treatment with favorable results. The aim of the study was to evaluate the efficacy and safety of bronchoscopic therapies for bronchial mucoepidermoid carcinoma in children. Clinical manifestations, multiple bronchoscopic interventions and outcomes in 6 children with bronchial mucoepidermoid carcinoma were retrospectively analyzed. The median age was 8.7 years (range 4 to 12 years). All the tumors were located in the lobar bronchus and were detected by computerized tomography. Diagnoses of low-grade mucoepidermoid carcinoma were made based on biopsies obtained via bronchoscopy. Five tumors were classified as intraluminal type and successfully eradicated by carbon dioxide cryotherapy and argon plasma coagulation under bronchoscopy. The other tumor in patient 3 was classified as the mixture type and could not be removed by a bronchoscopic, so left upper lobectomy was performed. For each patient, interventional procedures were conducted on the average for 6 times. No recurrence was detected by bronchoscopic inspections or computed tomography scans during follow-ups for 16-72 months. Multiple bronchoscopic procedures, as alternative treatments, are effective in removing bronchial mucoepidermoid carcinoma mucoepidermoid carcinoma in children without any major complications.

Bone marrow metastasis in primary bronchial mucoepidermoid carcinoma: a case report

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.

Endobronchial ultrasound‐guided fine‐needle aspiration cytology of bronchial low‐grade mucoepidermoid carcinoma: Rapid on‐site evaluation of cytopathologic findings

Bronchial mucoepidermoid carcinoma (MEC) is rare, comprising about 0.2% of primary lung tumors. Endobronchial ultrasound (EBUS) guided fine-needle aspiration (FNA) cytology is an integral tool in the diagnosis and staging of malignant lung tumors. Rapid on-site evaluation (ROSE) has been proven useful as a guide for assessing the adequacy and accuracy of the FNA samples. Therefore, comprehensive knowledge of diagnostic cytomorphologic findings of MEC is critical for ROSE. We reported a 46-year-old woman with 6 weeks of cough productive of yellow sputum that did not improve on antibiotics. A chest CT demonstrated a well-circumscribed nodule in the right lower lobe bronchus that extended into the lung parenchyma. EBUS-guided FNA was performed to obtain diagnostic materials. The ROSE of cytology specimen revealed numerous tight clusters of cells with well-defined, but scant cytoplasm. These cells were relatively small and bland with high N/C ratio, resembling benign ductal cells. Neither cilia nor intranuclear inclusions were noted. Focal extracellular metachromatic mucinous materials were also noted. A preliminary diagnosis of "low-grade epithelial neoplasm, favor low grade MEC" was rendered. The definitive diagnosis was confirmed by both cytology and core biopsy. EBUS-guided FNA cytology can be a reliable method for the diagnosis of bronchial low grade MEC. The cyto-morphology of ROSE can indicate the diagnosis of low grade MEC and direct the appropriate follow-up triage of the specimen.

Proton Beam Therapy for Inoperable Recurrence of Bronchial High-grade Mucoepidermoid Carcinoma

We report the case of a 17-year-old patient who received four courses of proton beam therapy for inoperable recurrent high-grade bronchial mucoepidermoid carcinoma of the chest wall and lymph nodes. The equivalent doses in conventional fractionation of 79.2-80.6 Gy were applied to the tumor from the first to third courses of proton beam therapy; the hemi-chest wall was also irradiated prophylactically in the third course. The irradiated tumor recurred marginally and liver metastasis developed, but tumor size within the irradiated field was suppressed. Proton beam therapy was also applied to the marginally recurrent tumor in the fourth course. The patient died of cancer about 5 years after the first course of proton beam therapy-about 9 years after the initial diagnosis and surgery. Repeated irradiation of the mediastinum and chest wall with photon radiotherapy is often limited by side-effects in the heart, esophagus and spinal cord. However, no severe late complications in critical organs were detected in this case. Only a Grade 2 skin reaction and lymphatic edema were observed. Therefore, high-dose proton beam therapy may be an option as a salvage therapy with less toxicity to normal tissues compared with photon radiotherapy and provide an alternative to repeated surgery.

Bronchial Mucoepidermoid Carcinoma in Children

Three cases of children, aged 7, 12 and 13 years, respectively, with bronchial mucoepidermoid carcinoma are presented. All patients were primarily misdiagnosed as pneumonitis following common symptoms of prolonged fever, cough, expectoration, and indirect signs of bronchial obstruction by chest roentgenogram, before the tumours in the main bronchi were revealed by chest computed tomography and bronchoscopy. After undergoing lobectomy and systematic lymph node dissection, all three patients recovered uneventfully. Histologically, all the cases were low-grade mucoepidermoid carcinoma; one case additionally had mediastinal lymph node metastasis. The patients have remained in good health during a follow-up of between 1.5 and 6 years. Despite its extremely rare occurrence in childhood, the possibility of bronchial mucoepidermoid carcinoma should be kept in mind when encountering a child presenting with symptoms of recurrent pneumonia.

Successful Treatment of Bronchial Mucoepidermoid Carcinoma in a Longstanding Collapsed Lung

Mucoepidermoid carcinoma is a rare tumor of the lung that accounts for 0.1% to 0.2% of all pulmonary tumors. Herein we report our experience with a patient who suffered from bronchial mucoepidermoid carcinoma and 2-year left lung atelectasis. The tumor originated from the orifice of the left upper bronchus and obstructed the left main stem bronchus. A left upper sleeve lobectomy was performed and the remaining atelectatic lower lobe was fully expanded by 6 months postoperatively. The patient's pulmonary function significantly improved.

High F-18 FDG Uptake in Bone Marrow by Cytokines Secreting Ectopic Mucoepidermoid Carcinoma

A 57-year-old woman, just returned from a bicycling holiday in the mountains, presented with discomfort, hoarseness and chronic cough complaints. After chest x-ray, bronchoscopy and fluoro-deoxy-glucose positron emission tomography/computed tomography (F-18 FDG PET/CT), a diagnosis of a tumor in the bronchus of the right upper lobe with obstruction pneumonia was made. After lobectomy of the right upper lobe, pathology revealed an ectopic bronchial low-grade mucoepidermoid carcinoma.The diffuse high FDG uptake in the bone marrow standardized uptake value (SUV mean 3.6 and max 5.2) is unlikely to be related to bone marrow stimulation due to pneumonia, but correlates with a high serum level of correlated with transforming growth factor-beta (TGF-beta1) secreted by the low-grade bronchial mucoepidermoid carcinoma.

Bronchial mucoepidermoid carcinoma with recurrent hemoptysis in a pregnant woman: Report of a case

Mucoepidermoid carcinoma of the tracheobronchial tree, which is thought to arise from the minor salivary gland tissue of the proximal airway, is an extremely rare neoplasm. We herein report a case of a 31-year-old pregnant woman in her 36th week, who complained of recurrent hemoptysis from bronchial mucoepidermoid carcinoma. As massive bleeding from the tumor was seen during a caesarean section, it was necessary to add bronchial artery embolization. The tumor was successfully removed by a sleeve resection of the left main bronchus after the embolization. The patient is doing well without any signs of recurrence at 3 years after undergoing the operation.

A Case of Intermediate Grade Bronchial Mucoepidermoid Carcinoma and Review in Korean Cases

Bronchial mucoepidermoid carcinoma is uncommon, representing 0.2% of all lung tumors. The disease usually presents with symptoms of airway obstruction and recurrent pneumonia. It is commonly classified into two grades in Korea, low and high. We report a case of a bronchial mucoepidermoid carcinoma in a 40-year-old woman who complained of symptoms of an upper respiratory infection. The histological grade after a bronchoscopic biopsy was intermediate. A left upper lobectomy was performed as treatment. The TNM stage of this case was IA (T1N0M0). In addition, 25 cases of bronchial mucoepidermoid carcinoma from 1984 in Korea are also reviewed from the viewpoint of the relationship between the histological grade, TNM stage and clinical course of the tumor.

Mucoepidermoid carcinoma of bronchus in a pediatric patient: 18F-FDG PET findings

In children, primary neoplasms of the tracheobronchial tree and lungs are rare; most are malignant. Of the primary malignant pulmonary neoplasms arising in childhood, mucoepidermoid carcinoma accounts for approximately 10%. Due to its well-confined local growth within the airway, mucoepidermoid carcinoma commonly produces respiratory symptoms from progressive tracheal or bronchial obstruction. Mucoepidermoid tumor has minimal metastatic potential in children, and local resection alone is the current treatment of choice. Early detection, diagnosis, and surgical resection of mucoepidermoid tumor are especially important in pediatric patients since the bulk of the remaining pulmonary parenchyma can be preserved, thereby decreasing the thoracic deformity and pulmonary functional morbidity. Radiographic and CT imaging findings of bronchial mucoepidermoid carcinoma in children have been described in several case reports. However, to the best of our knowledge, imaging findings of 2-((18)F)-fluoro-2-deoxy-D: -glucose positron emission tomography ((18)F-FDG PET) of mucoepidermoid carcinoma of the bronchus in pediatric patients have not been well established. We report a mucoepidermoid carcinoma arising from the right upper lobe bronchus in a 15-year-old girl with an emphasis on the (18)F-FDG PET findings.