Tracheal epithelial-myoepithelial carcinoma associated with sarcoid-like reaction: A case report

Primary salivary gland tumors of the lung: Two cases date report and literature review

Background

Primary salivary gland-type tumors of the lung (PSGTTL) is a rare intrathoracic malignant tumor that accounts for all lungs <1% of tumors.

Purpose

To introduce two case reports of primary lung salivary gland tumors, and highlight their diagnosis and treatment challenges.

Case report

The first case was a 30-year-old female, who complained of repeated coughing and dyspnea for 1 year and worsening for 2 days. Chest CT and bronchoscopy showed new organisms in the lower part of the trachea, that the bronchus obstruction accounted for 70%. The biopsy histology revealed a adenoid cystic carcinoma. She underwent extensive surgical resection and multiple radiotherapy, and She is recovering well from follow-up. The second case was a 70-year-old man, who complained of intermittent sputum blood for 2 years, worsening hemoptysis and chest tightness for 3 months. The new organisms was found in the upper trachea from Chest CT and bronchoscopy, and histological biopsy was used to diagnose epithelial myoepithelial carcinoma. He underwent twice bronchoscopy thermal ablation treatments. The follow-up is currently in good condition.

Conclusion

Primary lung salivary gland tumors are considered to be rare malignant tumors in the lungs. Early detection is advocated as late presentation with advanced tumor presents diagnostic and therapeutic challenges.

Bronchoscopic management of a primary endobronchial salivary epithelial-myoepithelial carcinoma: A case report

Here, we discussed a 55 y/o African man who recently immigrated from Nigeria to the United States and who presented to Parkland Memorial Hospital with a productive, intermittent cough of one year duration. The cough was associated with shortness of breath and chest pain. Cough was not associated with voice hoarseness, hemoptysis, melanoptysis, and wheezing. He had a computed tomography (CT) scan of the chest that showed a 1.9 cm mass in the right main stem bronchus with ipsilateral right lower lobe consolidation and bronchiectasis. The patient was seen by pulmonology who recommended bronchoscopy for diagnosis and possible intervention. Bronchoscopy showed a 90% obstructing mass in the proximal right mainstem bronchus and bronchus intermedius. The mass was large and endobronchial, circumferential, exophytic, and polypoid. The decision was made to undergo bronchoscopic tumor ablation using electrocautery snare, argon plasma coagulation (APC), suction, and forceps. The tumor was successful ablated. Microscopic examination revealed eosinophilic ducts tightly coupled with a surrounding layer of clear cell myoepithelial cells and the diagnosis of epithelial-myoepithelial carcinoma (EMC) of the lung was made. The patient was discharged from the hospital with scheduled outpatient visits for monitoring of the carcinoma by pulmonology and thoracic surgery. Unfortunately, he was lost to follow up.

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Primary salivary epithelial-myoepithelial carcinoma are extremely rare malignancies found in the airways.

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This type of tumor can be seen in patients who present with chronic cough without other symptomatology.

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Although management is primarily surgical, here we report the successful bronchoscopic removal of this malignancy.

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There were no complications following the bronchoscopic removal of the tumor.