Mucoepidermoid lung carcinoma in child

Primary Mucoepidermoid Carcinoma of the Lung Coexisting With Pulmonary Tuberculosis: A Rare Case Report

Mucoepidermoid carcinoma (MEC) is a well-established neoplasm of the salivary glands. However, the MEC of the lung is an exceedingly rare neoplasm that falls under the category of salivary gland-type tumors of the lung. Pulmonary MEC is recognized for its indolent progression. Pulmonary tuberculosis (TB) is a prevalent infectious disease in India and ranks among the leading causes of death from infectious diseases. Nevertheless, the co-occurrence of pulmonary MEC with pulmonary TB is a rare phenomenon that has not been documented in the literature. In this report, we describe a 54-year-old male patient who presented with symptoms of dysphagia, weight loss, and fever. Histopathological examination diagnosed him with pulmonary MEC, and concurrent cytology and Gene-Xpert tests confirmed tuberculosis. This case represents the first documented instance of this particular co-occurrence. It underscores the limitations of radiology in diagnosing such a rare neoplasm, especially when there is an absence of lung parenchyma infiltration and a mass lesion. Additionally, this case supports the possibility of an interdependent relationship between malignancies and tuberculosis.

Mucoepidermoid lung carcinoma in a pediatric patient confused with pneumonia

Mucoepidermoid carcinoma (MEC) is a common type of salivary gland malignancy; however, rarely, MEC can arise from the lung. This disease has a non-specific presentation and is often overlooked. Histologically, MEC can be classified into low-grade and high-grade forms. Surgical resection is the optimal treatment for low-grade tumors. In this article, we report a case of MEC in a 5-year-old girl who was initially misdiagnosed with pneumonia. The histological results revealed MEC. Thus, clinicians and radiologists should consider the possibility of this rare entity in patients who fail to respond to antibiotic treatments, even among the pediatric population.

Bronchial Foreign Body Alerting of a Bronchial Tumor: The Need of a Follow-Up Radiography

Lung tumors are extremely rare in the pediatric population, comprising only 0.2% of all malignancies in children. Among them, mucoepidermoid carcinoma (MEC) is even rarer with a reported frequency of 0.1% to 0.2%. MEC is defined by the World Health Organization as a tumor characterized by a combination of mucus-secreting, squamous, and intermediate cell types. We describe the case of a 4-year-old girl who presented with a history of intermittent fever and nonproductive cough of 1-month duration after foreign body aspiration. The chest X-ray showed complete collapse of the left lung. After removal of the foreign body, the lung expanded well after. However, the control chest X-ray done after 5 days showed again complete collapse of the left lung. The biopsy specimen taken during bronchoscopy confirmed the diagnosis of low-grade MEC. Fluorescence in situ hybridization (FISH) confirmed the presence of MAML2 rearrangement. Complete surgical resection with preservation of lung parenchyma was performed. No adjuvant therapy was needed. Repeat bronchoscopy was performed 2 months after surgery and showed no recurrence of the tumor. In conclusion, a remote chest X-ray after removal of a foreign body is necessary to avoid missing a rare serious underlying disease such as MEC. According to the size and the location of the tumor, complete surgical removal is sufficient without additional treatment in case of low-grade tumor. The presence of MAML2 rearrangement confers a favorable outcome and may have long-term implications for the clinical management.

Low-Grade and High-Grade Mucoepidermoid Carcinoma of the Lung: CT Findings and Clinical Features of 17 Cases

OBJECTIVE

The objective of our study was to characterize the CT features and clinical findings of low-grade and high-grade mucoepidermoid carcinoma (MEC) of the lung.

MATERIALS AND METHODS

The CT findings and clinical information of 17 consecutive patients with primary low-grade (n = 11) or high-grade (n = 6) MEC were analyzed retrospectively. We assessed tumor location, size, contour, margin, density, calcification, obstructive changes, presence of metastasis, and enhancement.

RESULTS

In patients with low-grade MEC, tumor location was central in 10 and peripheral in one. In contrast, one and five tumors in patients with high-grade MEC were central and peripheral, respectively. There was a significant difference between central and peripheral locations among tumor grades (p = 0.005). In low-grade MECs, tumor contour was smoothly oval (n = 3) or spheric (n = 4); four were lobular. In five patients with low-grade MEC, tumors had well-defined margins; margins in the other six were poorly defined. Tumor density was homogeneous and heterogeneous in eight and three low-grade tumors, respectively. All six high-grade tumors had heterogeneous density, lobular contours, and poorly defined margins. Enhancement in both low-grade and high-grade tumors was greater than that of chest wall muscles, and low-grade tumors showed greater enhancement (46.90 ± 20.44 HU) than did high-grade tumors (22.50 ± 8.38 HU) (p = 0.015).

CONCLUSION

A markedly enhanced homogeneous central bronchial nodule or mass may suggest low-grade MEC. High-grade MEC tends to be peripheral, to have poorly defined margins, and to be lobular, heterogeneous nodules or masses with less enhancement.