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Yu XH, Wang WX, Yang DS, Gong LH. Left lower lobe sleeve resection for the clear cell variant of pulmonary mucoepidermoid carcinoma: A case report. World J Clin Cases 2024; 12:1422-1429. [PMID: 38576804 PMCID: PMC10989443 DOI: 10.12998/wjcc.v12.i8.1422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/08/2024] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Pulmonary mucoepidermoid carcinoma (PMEC) is a rare malignancy that arises from minor salivary glands within the tracheobronchial tree. The clear cell variant of PMEC is exceptionally uncommon and presents notable diagnostic challenges, primarily attributable to its morphological similarity to other tumors containing clear cells. CASE SUMMARY A 22-year-old male, formerly in good health, came in with a two-month duration of persistent cough and production of sputum. Subsequent imaging and bronchoscopy examinations revealed a 2 cm tumor in the distal left main bronchus, which resulted in complete atelectasis of the left lung. Further assessment via positron emission tomography/computed tomography scans and endoscopic biopsy confirmed the primary malignant nature of the tumor, characterized by clear cell morphology in most of the tumor cells. The patient underwent a left lower lobe sleeve resection accompanied by systematic mediastinal lymph node dissection. Molecular pathology analysis subsequently revealed a CRTC3-MAML2 gene fusion, leading to a definitive pathological diagnosis of the clear cell variant of PMEC, staged as T2N0M0. After surgery, the patient experienced a smooth recovery and exhibited no signs of recurrence during the one-and-a-half-year follow-up period. CONCLUSION This article describes an unusual case of a clear cell variant of PMEC characterized by the presence of a CRTC3-MAML2 gene fusion in a 22-year-old male. The patient underwent successful left lower lobe sleeve resection. This case underscores the distinctive challenges associated with diagnosing and treating this uncommon malignancy, underscoring the importance of precise diagnosis and personalized treatment strategies.
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Affiliation(s)
- Xiao-Hui Yu
- Department of Pathology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
| | - Wen-Xiang Wang
- The Second Department of Thoracic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
| | - De-Song Yang
- The Second Department of Thoracic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
| | - Liang-Hui Gong
- The Second Department of Thoracic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
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Takamori S, Yatabe Y, Osoegawa A, Aokage K, Yoshioka H, Miyoshi T, Mimae T, Endo M, Hattori A, Yotsukura M, Isaka T, Isaka M, Maniwa T, Nakajima R, Watanabe SI. Rare but clinically important salivary gland-type tumor of the lung: A review. Jpn J Clin Oncol 2024; 54:121-128. [PMID: 37952098 DOI: 10.1093/jjco/hyad154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023] Open
Abstract
Salivary gland-type tumor (SGT) of the lung, which arises from the bronchial glands of the tracheobronchial tree, was first recognized in the 1950s. SGT represents less than 1% of all lung tumors and is generally reported to have a good prognosis. Mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (ACC) are the two most common subtypes, comprising more than 90% of all SGTs. The reported 5-year survival rate of patients with SGT is 63.4%. Because this type of tumor develops in major bronchi, patients with SGT commonly present with symptoms of bronchial obstruction, including dyspnea, shortness of breath, wheezing, and coughing; thus, the tumor is usually identified at an early stage. Most patients are treated by lobectomy and pneumonectomy, but bronchoplasty or tracheoplasty is often needed to preserve respiratory function. Lymphadenectomy in the surgical resection of SGT is recommended, given that clinical benefit from lymphadenectomy has been reported in patients with MEC. For advanced tumors, appropriate therapy should be considered according to the subtype because of the varying clinicopathologic features. MEC, but not ACC, is less likely to be treated with radiation therapy because of its low response rate. Although previous researchers have learned much from studying SGT over the years, the diagnosis and treatment of SGT remains a complex and challenging problem for thoracic surgeons. In this article, we review the diagnosis, prognosis, and treatment (surgery, chemotherapy, and radiotherapy) of SGT, mainly focusing on MEC and ACC. We also summarize reports of adjuvant and definitive radiation therapy for ACC in the literature.
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Affiliation(s)
- Shinkichi Takamori
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Yasushi Yatabe
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Atsushi Osoegawa
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Keiju Aokage
- Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Hiroshige Yoshioka
- Department of Thoracic Oncology, Kansai Medical University Hospital, Osaka, Japan
| | - Tomohiro Miyoshi
- Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Takahiro Mimae
- Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan
| | - Makoto Endo
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Aritoshi Hattori
- Division of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
| | - Masaya Yotsukura
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Tetsuya Isaka
- Department of Thoracic Surgery, Kanagawa Cancer Center, Kanagawa, Japan
| | - Mitsuhiro Isaka
- Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Tomohiro Maniwa
- Department of General Thoracic Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Ryu Nakajima
- Division of Thoracic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Shun-Ichi Watanabe
- Division of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
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Xie WX, Liu R, Li Z, Zhou PL, Duan LN, Fu DD. Mucoepidermoid carcinoma of the lung with hemoptysis as initial symptom: A case report. World J Clin Cases 2023; 11:7136-7143. [PMID: 37946783 PMCID: PMC10631410 DOI: 10.12998/wjcc.v11.i29.7136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/27/2023] [Accepted: 09/18/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Mucoepidermoid carcinoma of the lung is a rare malignant tumor, accounting for 0.1%-0.2% of all lung malignancies. It is a primary salivary gland tumor of the lung. Surgical resection is the primary treatment for pulmonary mucoepidermoid carcinoma, for which there has been no standardized treatment strategy. This article reports a case of a young woman with pulmonary mucoepidermoid carcinoma with hemoptysis as the first symptom. CASE SUMMARY A 24-year-old female patient presented with "4 d of hemoptysis" as the chief complaint. She had no special history and denied any smoking or drinking history. Physical examination revealed that the vital signs were stable and scattered small wet rales were heard in the left lung. After admission, the lung tumor markers were checked, and no abnormalities were found. After completing the bronchoscopy, a spherical lesion was observed at the main bronchus 1.5 cm away from the protubercle, with obvious pulsation and little blood seepage on the surface, and histopathological biopsy results showed acute and chronic inflammation. She was transferred to the Department of Thoracic Surgery for surgical treatment on the 16th day after admission. After exclusion of surgical conjunctures, the patient underwent resection of the tumor in the left main bronchus with single-pore video-assisted thoracic surgery on the 19th day after admission. The postoperative histopathological biopsy results showed mucoepidermoid carcinoma of the lung. The patient and her family refused to complete genetic testing and she was discharged from the hospital on the 8th day after surgery. During the follow-up period, the patient experienced shortness of breath after feeling active and had no special discomfort. CONCLUSION We have documented a case of moderately differentiated mucoepidermoid lung cancer with hemoptysis as the first symptom to improve clinicians' understanding of the disease and provide a new dimension of thinking for its future diagnosis and treatment.
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Affiliation(s)
- Wen-Xing Xie
- Department of Respiratory Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Rong Liu
- Department of Respiratory Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Zheng Li
- Department of Respiratory Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Pei-Ling Zhou
- Department of Respiratory Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Li-Na Duan
- Department of Respiratory Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Dan-Dan Fu
- Department of Respiratory Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
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Huang Y, Fu Y, Sun J, Xu B, Wu L, Tang LF. Pulmonary mucoepidermoid carcinoma in children: two case reports and a review of the literature. Front Pediatr 2023; 11:1232185. [PMID: 37772041 PMCID: PMC10522853 DOI: 10.3389/fped.2023.1232185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/29/2023] [Indexed: 09/30/2023] Open
Abstract
Pulmonary mucoepidermoid carcinoma (PMEC) is a rare tumor, particularly in children, and its clinical manifestations vary. When the tumor is small, it may be asymptomatic; however, with larger tumors, patients may present with symptoms such as recurring pneumonia, atelectasis, persistent cough, chest pain, and even hemoptysis. PMEC appears as an exophytic intrabronchial mass. This study aims to report on the clinical manifestations, imaging findings, treatment approaches, and prognosis of two children diagnosed with PMEC at our hospital between January 2018 and December 2022. The age of onset for both children was 9 years, and the masses were located in the right upper lobe bronchi. Following surgical treatment, both patients showed a good prognosis. In addition, we conducted a comprehensive review of the relevant literature to enhance the overall understanding of PMEC.
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Affiliation(s)
- Yuan Huang
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Endoscopy Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yong Fu
- Department of Otorhinolaryngology-Head and Neck Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jing Sun
- Department of Otorhinolaryngology-Head and Neck Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Bin Xu
- Department of Otorhinolaryngology-Head and Neck Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lei Wu
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Endoscopy Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lan-fang Tang
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Endoscopy Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Samar MR, Ejaz A, Nida-E-Zehra, Rashid YA. Primary endo-bronchial muco-epidermoid carcinoma in a 22-year-old female: A case report. Int J Surg Case Rep 2023; 109:108562. [PMID: 37499349 PMCID: PMC10413083 DOI: 10.1016/j.ijscr.2023.108562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023] Open
Abstract
INTRODUCTION Muco-epidermoid carcinomas are primarily the subtypes of salivary gland tumors that can rarely originate within the respiratory tract. Our case highlights the occurrence of an unusual, localized, endo-bronchial muco-epidermoid cancer. We aim to strengthen the evidence of occurrence of this distinct variety of lung cancer in our country as little is known about this rare subclass of lung cancer. CASE PRESENTATION We report a case of a 22-year-old female patient, belonging to Karachi, Pakistan, who presented with respiratory symptoms and upon work-up, was diagnosed with a low-grade, localized muco-epidermoid carcinoma of the lung. She underwent surgical resection successfully and was advised to get evaluated for adjuvant radiotherapy. CLINICAL DISCUSSION Localized low-grade MEC respond well to surgical resection in contrast to high-grade MEC which is associated with poor prognosis thus requiring adjuvant radiotherapy to improve survival outcomes. CONCLUSION Lung cancers can be unusually of muco-epidermoid origin. It has been uncommonly found in the world including Pakistan. Special attention with validated data is therefore needed, for developing guidelines for the optimal management of such neoplasms.
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Affiliation(s)
- Mirza Rameez Samar
- Department of Medical Oncology, The Aga Khan University Hospital, Pakistan.
| | - Aneeqa Ejaz
- Department of Medicine, The Aga Khan University Hospital, Pakistan
| | - Nida-E-Zehra
- Department of Medical Oncology, The Aga Khan University Hospital, Pakistan
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Ding YM, Wang Q. Endoscopic resection of bronchial mucoepidermoid carcinoma in a young adult man: A case report and review of literature. World J Clin Cases 2022; 10:11921-11928. [PMID: 36405259 PMCID: PMC9669874 DOI: 10.12998/wjcc.v10.i32.11921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/22/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND 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.
CASE SUMMARY 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.
CONCLUSION Interventional bronchoscopy can be considered for treatment of low-grade bronchial MEC, with few complications and preserved lung function.
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Affiliation(s)
- Yong-Min Ding
- Department of Respiratory and Critical Care Medicine, Shengzhou People’s Hospital, Shengzhou 312499, Zhejiang Province, China
| | - Qing Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
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Shumin Hu, Jiali Gong, Xiu Zhu, Hongyang Lu. Pulmonary Salivary Gland Tumor, Mucoepidermoid Carcinoma: A Literature Review. J Oncol 2022; 2022:9742091. [PMID: 36385961 DOI: 10.1155/2022/9742091] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/10/2022] [Accepted: 08/31/2022] [Indexed: 01/25/2023]
Abstract
Pulmonary mucoepidermoid carcinoma (PMEC) is the most common malignant salivary gland tumor in the lungs and accounts for 0.1-0.2% of all lung malignancies in adults. It has no specific epidemiological or clinical characteristics. Correct diagnosis requires the combined examinations of images, laboratories, pathology, and immunohistochemistry (IHC) as well as molecular characteristics. PMEC tumors are characterized by squamous, intermediate, and mucus-secreting cells. Currently, histological appearance, mitotic frequency, cellular atypia, and necrocytosis allow the classification of PMEC into low grade or high grade. Molecular changes are crucial to pathological diagnosis. The driver of PMEC seems to be the fusion protein MECT1-MAML2 that is generated from a genetic mutation in t (11; 19) (q21; p13), while other gene mutations are also reported. However, no treatment of PMEC exists so far; surgical excision is still the primary treatment, while the efficacies of chemotherapy or radiotherapy are undefined. Tyrosine kinase inhibitor (TKI) therapy and immunotherapy showed to have significant therapeutic effects but require more investigation and better understanding. This review focuses on the clinical characteristics, imaging and pathologic features, immunohistochemical examination, mutation analysis, differential diagnosis, prognosis, and treatment of PMEC.
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Wu LL, Qian JY, Li CW, Zhang Y, Lin WK, Li K, Li ZX, Xie D. The Clinical and Prognostic Characteristics of Primary Salivary Gland-Type Carcinoma in the Lung: A Population-Based Study. Cancers (Basel) 2022; 14:cancers14194668. [PMID: 36230589 PMCID: PMC9564309 DOI: 10.3390/cancers14194668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to explore the clinical and prognostic characteristics of primary salivary gland-type carcinoma (SGC). The entire cohort from the Surveillance, Epidemiology, and End Results database was used to calculate the SGC proportion. In total, 253,096 eligible patients, including 165,715 adenocarcinomas (ADCs), 87,062 squamous cell carcinomas (SCCs), and 319 SGCs, were selected to perform survival analyses. The data of 42 SGC patients from our hospital showed postoperative survival. Overall survival (OS) curves for different histological and surgical types were presented. The proportion of primary SGCs was 0.8 per 1000 patients. Patients with age ≤ 64 years old had a much higher proportion of SGC than those patients with age >64 years old. After adjusting for other confounders, among ADCs, SCCs, and SGC, SGCs had the best prognosis (HR 0.361, p < 0.001). Moreover, the 5-year OS rates of SGC patients were 55% and 7% in the group with surgery or without surgery, respectively (p < 0.001). The data of 42 patients from our hospital also showed a good survival of SGCs. Lobectomy improved the survival of SGCs significantly (adjusted HR 0.439, p = 0.016). In conclusion, pulmonary SGCs had the best prognosis among ADCs, SCCs, and SGCs. In addition, lobectomy could further improve the prognostic outcomes of SGCs.
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Affiliation(s)
- Lei-Lei Wu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China
| | - Jia-Yi Qian
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China
| | - Chong-Wu Li
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China
| | - Yu Zhang
- School of Medicine, Tongji University, Shanghai 200092, China
| | - Wei-Kang Lin
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China
| | - Kun Li
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China
| | - Zhi-Xin Li
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China
- Correspondence: (Z.-X.L.); (D.X.); Tel.: +86-139-1891-8907 (D.X.)
| | - Dong Xie
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China
- Correspondence: (Z.-X.L.); (D.X.); Tel.: +86-139-1891-8907 (D.X.)
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Thierauf JC, Farahani AA, Indave BI, Bard AZ, White VA, Smith CR, Marble H, Hyrcza MD, Chan JKC, Bishop J, Shi Q, Ely K, Agaimy A, Martinez-Lage M, Nose V, Rivera M, Nardi V, Dias-Santagata D, Garg S, Sadow P, Le LP, Faquin W, Ritterhouse LL, Cree IA, Iafrate AJ, Lennerz JK. Diagnostic Value of MAML2 Rearrangements in Mucoepidermoid Carcinoma. Int J Mol Sci 2022; 23:4322. [PMID: 35457138 PMCID: PMC9026998 DOI: 10.3390/ijms23084322] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023] Open
Abstract
Mucoepidermoid carcinoma (MEC) is often seen in salivary glands and can harbor MAML2 translocations (MAML2+). The translocation status has diagnostic utility as an objective confirmation of the MEC diagnosis, for example, when distinction from the more aggressive adenosquamous carcinoma (ASC) is not straightforward. To assess the diagnostic relevance of MAML2, we examined our 5-year experience in prospective testing of 8106 solid tumors using RNA-seq panel testing in combinations with a two-round Delphi-based scenario survey. The prevalence of MAML2+ across all tumors was 0.28% (n = 23/8106) and the majority of MAML2+ cases were found in head and neck tumors (78.3%), where the overall prevalence was 5.9% (n = 18/307). The sensitivity of MAML2 for MEC was 60% and most cases (80%) were submitted for diagnostic confirmation; in 24% of cases, the MAML2 results changed the working diagnosis. An independent survey of 15 experts showed relative importance indexes of 0.8 and 0.65 for "confirmatory MAML2 testing" in suspected MEC and ASC, respectively. Real-world evidence confirmed that the added value of MAML2 is a composite of an imperfect confirmation test for MEC and a highly specific exclusion tool for the diagnosis of ASC. Real-world evidence can help move a rare molecular-genetic biomarker from an emerging tool to the clinic.
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Affiliation(s)
- Julia C. Thierauf
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital and Research Group Molecular Mechanisms of Head and Neck Tumors, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Alex A. Farahani
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - B. Iciar Indave
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - Adam Z. Bard
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Valerie A. White
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - Cameron R. Smith
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Hetal Marble
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Martin D. Hyrcza
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB 2500, Canada;
| | - John K. C. Chan
- Department of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China;
| | - Justin Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Qiuying Shi
- Department of Pathology, Emory University Hospital, Atlanta, GA 30322, USA;
| | - Kim Ely
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Abbas Agaimy
- Institute of Pathology, Friedrich Alexander University Erlangen-Nürnberg, University Hospital, 91054 Erlangen, Germany;
| | - Maria Martinez-Lage
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Vania Nose
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Miguel Rivera
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Valentina Nardi
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Dora Dias-Santagata
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Salil Garg
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Peter Sadow
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Long P. Le
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - William Faquin
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Lauren L. Ritterhouse
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Ian A. Cree
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - A. John Iafrate
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Jochen K. Lennerz
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
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10
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Kimura M, Miyajima K, Ishikawa R, Yamada Y, Kono T, Okunaka T, Iwaya K, Ikeda N. Photodynamic therapy for pulmonary mucoepidermoid carcinoma. Respir Med Case Rep 2021; 33:101431. [PMID: 34401275 PMCID: PMC8348553 DOI: 10.1016/j.rmcr.2021.101431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/21/2021] [Accepted: 05/11/2021] [Indexed: 12/26/2022] Open
Abstract
Pulmonary mucoepidermoid carcinoma (PMEC) are rare, accounting for 0.1–0.2% of all malignant lung tumors. Furthermore, endobronchial lesions are rare and are more commonly found in the segmental or lobar bronchi. We present, to the best of our knowledge, the first case of successful treatment with photodynamic therapy (PDT) for PMEC. A 77-year-old male presented with cough and hemosputum for 4 months. Chest computed tomography showed a mass in the right intermediate bronchus. Endobronchial biopsy revealed a diagnosis of PMEC. An optimal surgical technique to preserve respiratory function was desirable as most of the tumor emerged from the bronchial glands in the central airways and was of low-grade type. Hence, PDT was performed. Repeat bronchoscopies were performed 5 years after the PDT and showed no evidence of tumor recurrence. PDT is more likely to be effective for low-grade PMECs that are visible on bronchoscopy.
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Affiliation(s)
- Masakazu Kimura
- Department of Thoracic Surgery, Niizashiki Central General Hospital, 1-7-2 Tohoku, Niiza, Saitama, 352-0001, Japan
- Corresponding author. Niizasiki Central General Hospital, 1-7-2 Tohoku, Niiza, Saitama, 352-0001, Japan.
| | - Kuniharu Miyajima
- Department of Thoracic Surgery, Niizashiki Central General Hospital, 1-7-2 Tohoku, Niiza, Saitama, 352-0001, Japan
| | - Rinako Ishikawa
- Department of Thoracic Surgery, Niizashiki Central General Hospital, 1-7-2 Tohoku, Niiza, Saitama, 352-0001, Japan
| | - Yuki Yamada
- Department of Thoracic Surgery, Niizashiki Central General Hospital, 1-7-2 Tohoku, Niiza, Saitama, 352-0001, Japan
| | - Takafumi Kono
- Department of Thoracic Surgery, Niizashiki Central General Hospital, 1-7-2 Tohoku, Niiza, Saitama, 352-0001, Japan
| | - Tetuya Okunaka
- Department of Thoracic Surgery, Niizashiki Central General Hospital, 1-7-2 Tohoku, Niiza, Saitama, 352-0001, Japan
| | - Keiichi Iwaya
- Department of Diagnostic Pathology, Kyoundo Hospital, 1-8 Kanda Surugudai, Chiyoda, Tokyo, 101-0062, Japan
| | - Norihiko Ikeda
- Department of Thoracic Surgery, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku, Tokyo, 160-0023, Japan
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11
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Qiu L, Song P, Chen P, Wang H, Li F, Shu M, Gong GC, Song X, Huang C, Jia H, Li N, Zhang G. Clinical Characteristics and Prognosis of Patients With Pulmonary Mucoepidermoid Carcinoma: A SEER-Based Analysis. Front Oncol 2021; 11:601185. [PMID: 33747918 PMCID: PMC7973275 DOI: 10.3389/fonc.2021.601185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/07/2021] [Indexed: 02/05/2023] Open
Abstract
Background Primary pulmonary mucoepidermoid carcinoma (PMEC) is an extremely rare malignancy. Its clinical characteristics and prognosis are not fully understood. This study evaluated clinical characteristics and prognostic factors of PMEC and established a nomogram to predict its 1-, 3-, 5- and 10-year cancer-specific survival (CSS) rates. Methods In the Surveillance, Epidemiology, and End Results database from January 1, 2016 to December 31, 2016, patients pathologically diagnosed with PMEC were identified. Kaplan-Meier analysis and Cox regression were performed to evaluate the CSS stratified by different covariates. A predictive nomogram model was built and validated by the concordance index (C-index) and calibration curves. Results A total of 585 PMEC patients were identified. A total of 408 (70%) of patients were placed into the training cohort, and 177 (30%) patients were placed into the validation cohort. The 5- and 10-year CSS rates of stage I-II PMEC patients were 91.4 and 88.9, respectively. The 1-, 3- and 5-year CSS rates of stage III-IV PMEC were 56.5, 39.45, and 32.1%, respectively. Survival curves showed that older age, large tumor size, poor differentiation, and high TNM stage were associated with a significantly worse prognosis. CSS outcomes were significantly better in patients who received surgical treatments (surgical alone, surgery plus radiation and/or chemotherapy). Patients who received radiation and/or chemotherapy had the worst prognosis. Multivariate Cox results revealed that covariates, including age, tumor laterality, tumor sizes, pathological differentiation, lymph node metastasis, distant metastasis, TNM stage and therapy, were independent prognostic factors for PMEC. These factors were used to construct a nomogram. The C-index of the nomogram was 0.921. The calibration curve presented favorable consistency between the predicted CSS and actual observations. This nomogram was validated by the validation cohort. The C-index of the validation cohort was 0.968. Conclusion Age, bilateral tumors, tumor size, pathological differentiation grade, lymph node metastasis, distant metastasis, TNM stage and therapy were independent prognostic factors of PMEC patients. The first nomogram for predicting the CSS of PMEC was built and validated, showing its potential value in practice.
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Affiliation(s)
- Lingxiao Qiu
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Pan Song
- Department of Urology, West China Hospital of Sichuan University, Chengdu, China
| | - Pingmei Chen
- Department of Neonatology, West China Guang'an Hospital, Sichuan University, Guang'an, China
| | - Huaqi Wang
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Zhengzhou Key Laboratory for Chronic Respiratory Disease, Zhengzhou, China.,Henan Provincial Respiratory Medicine Center, Zhengzhou, China
| | - Fangfang Li
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengxuan Shu
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Gen-Cheng Gong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiangjin Song
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chun Huang
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongxia Jia
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Nana Li
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guojun Zhang
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Zhengzhou Key Laboratory for Chronic Respiratory Disease, Zhengzhou, China.,Henan Provincial Respiratory Medicine Center, Zhengzhou, China
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12
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Ban X, Shen X, Hu H, Zhang R, Xie C, Duan X, Zhou C. Predictive CT features for the diagnosis of primary pulmonary mucoepidermoid carcinoma: comparison with squamous cell carcinomas and adenocarcinomas. Cancer Imaging 2021; 21:2. [PMID: 33407915 PMCID: PMC7789188 DOI: 10.1186/s40644-020-00375-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 12/18/2020] [Indexed: 12/03/2022] Open
Abstract
Background To determine the predictive CT imaging features for diagnosis in patients with primary pulmonary mucoepidermoid carcinomas (PMECs). Materials and methods CT imaging features of 37 patients with primary PMECs, 76 with squamous cell carcinomas (SCCs) and 78 with adenocarcinomas were retrospectively reviewed. The difference of CT features among the PMECs, SCCs and adenocarcinomas was analyzed using univariate analysis, followed by multinomial logistic regression and receiver operating characteristic (ROC) curve analysis. Results CT imaging features including tumor size, location, margin, shape, necrosis and degree of enhancement were significant different among the PMECs, SCCs and adenocarcinomas, as determined by univariate analysis (P < 0.05). Only lesion location, shape, margin and degree of enhancement remained independent factors in multinomial logistic regression analysis. ROC curve analysis showed that the area under curve of the obtained multinomial logistic regression model was 0.805 (95%CI: 0.704–0.906). Conclusion The prediction model derived from location, margin, shape and degree of enhancement can be used for preoperative diagnosis of PMECs.
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Affiliation(s)
- Xiaohua Ban
- Department of Medical Imaging Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Xinping Shen
- Department of Radiology, The University of Hong Kong-Shenzhen Hospital, No.1, Haiyuan Road Futian District, Shenzhen, 518000, People's Republic of China
| | - Huijun Hu
- Department of Radiology, Guangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Rong Zhang
- Department of Medical Imaging Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Chuanmiao Xie
- Department of Medical Imaging Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Xiaohui Duan
- Department of Radiology, Guangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, Guangdong, 510120, People's Republic of China.
| | - Cuiping Zhou
- Department of Radiology, The University of Hong Kong-Shenzhen Hospital, No.1, Haiyuan Road Futian District, Shenzhen, 518000, People's Republic of China.
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13
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Dell'Amore A, Chen L, Monaci N, Campisi A, Wang Z, Mammana M, Pangoni A, Zhao H, Schiavon M, Yao F, Rea F. Total Lung-sparing Surgery for Tracheobronchial Low-grade Malignancies. Ann Thorac Surg 2020; 112:450-458. [PMID: 33096073 DOI: 10.1016/j.athoracsur.2020.08.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/16/2020] [Accepted: 08/22/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Total lung-sparing tracheobronchial sleeve resections are a step forward in the treatment of low-grade bronchial tumors in which minimal resection margins are required to achieve complete control of the disease. METHODS This study retrospectively collected data on patients who underwent total lung-sparing procedures for low-grade tracheobronchial tumors at 2 thoracic surgical centers from January 1984 to October 2019. RESULTS The study included 98 patients, 46 -female (47%) and 52 -male (53%), with a median age of 39 years (range, 7 to 70 years). Thirty-four patients underwent operative endoscopy before surgery (32 had laser treatment, and 2 had endobronchial stenting). The surgical resections were as follows: 9 (9%), tracheal carina; 18 (18%), second carina; 31 (32%), left main bronchi; 25 (26%), right main bronchi; and 15 (15%), intermediate bronchus. The median length of the resected bronchus was 2.2 cm. The median postoperative in-hospital stay was 8 days, and no perioperative mortality was observed. Postoperative complications were recorded in 26-patients (27%). The final histologic classification was as follows: 37 typical carcinoids (38%); 10 atypical carcinoids (10%); 29 adenoid cystic carcinomas (30%); 15 mucoepidermoid carcinomas (15%); 6 inflammatory myofibroblastic tumors (6%); and 1 glomic tumor (1%). Twenty-two patients had positive resection margins and underwent adjuvant radiotherapy. Three patients with adenoid cystic carcinoma had recurrences (1 local and 2 systemic). After a median follow-up time of 54.5 months (range, 4 to 360 months), the overall actuarial 5-year survival was 97%. CONCLUSIONS Total lung-sparing tracheobronchial sleeve resection for low-grade malignant disease requires advanced surgical skills, but the hospital morbidity and mortality are very low. This technique is adequate and safe for highly selected patients with low-grade endobronchial malignant diseases, and its use should be encouraged in experienced centers.
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Affiliation(s)
- Andrea Dell'Amore
- Thoracic-Surgery Unit, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy.
| | - Liang Chen
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Nicola Monaci
- Thoracic-Surgery Unit, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | - Alessio Campisi
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Zhexin Wang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Marco Mammana
- Thoracic-Surgery Unit, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | - Alessandro Pangoni
- Thoracic-Surgery Unit, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | - Heng Zhao
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Marco Schiavon
- Thoracic-Surgery Unit, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | - Feng Yao
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Federico Rea
- Thoracic-Surgery Unit, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
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14
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Wang Y, Cai S, Xue Q, Mu J, Gao Y, Tan F, Mao Y, Wang D, Zhao J, Gao S, He J. Treatment outcomes of patients with tracheobronchial mucoepidermoid carcinoma compared with those with adenoid cystic carcinoma. Eur J Surg Oncol 2020; 46:1888-1895. [PMID: 32418755 DOI: 10.1016/j.ejso.2020.04.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/25/2020] [Accepted: 04/10/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Tracheobronchial mucoepidermoid carcinoma (TMEC) is an extremely rare salivary gland-type neoplasm. We aimed to explore the clinical characteristics and prognosis of TMEC and to compare them with those of another rare salivary gland-type neoplasm, tracheobronchial adenoid cystic carcinoma (TACC). METHOD We performed a retrospective review of all patients pathologically diagnosed with TMEC between 1965 and 2017 at our institution. We reviewed the patients' clinical characteristics, treatment methods and outcomes and compared the results of TMEC and TACC patients. RESULTS A total of 115 consecutive patients, including 107 who underwent surgery and 8 who received nonoperative therapy, were included in our study. The 1-, 2-, and 5-year survival rates were 97.89%, 94.17%, and 90.50%, respectively, in the surgical group and 83.33%, 41.67% and 0.00%, respectively, in the nonoperative group. The multivariate analysis showed that N stage was an independent prognostic factor for overall survival (OS). TMEC patients were younger, had a shorter complaint duration, had fewer symptoms, had more bronchial tumors, and were more likely to undergo surgical treatment and achieve an R0 resection (surgically treated patients) than TACC patients; furthermore, TMEC patients had a significantly better OS than TACC patients (P < 0.050). CONCLUSIONS TMEC has different characteristics and a better prognosis than TACC, which may reflect the different biological behaviors of these two salivary gland neoplasms. Radical treatment and close follow-up are critical for surgically treated TMEC patients with lymph node metastasis.
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Affiliation(s)
- Yalong Wang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Songhua Cai
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - Qi Xue
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Juwei Mu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - Yushun Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Fengwei Tan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yousheng Mao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Dali Wang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Jun Zhao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Shugeng Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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15
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Bajpai J, Rajagopal TV, Kant S, Shukla S, Pradhan A, Bajaj DK. Curious case of primary pulmonary mucoepidermoid carcinoma. J Family Med Prim Care 2019; 8:4039-4041. [PMID: 31879657 PMCID: PMC6924229 DOI: 10.4103/jfmpc.jfmpc_731_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 09/17/2019] [Accepted: 09/30/2019] [Indexed: 11/09/2022] Open
Abstract
Pulmonary mucoepidermoid carcinoma (MEC) is an uncommon tumor constituting only 0.1% to 0.2% of all lung carcinoma. It is classified under “salivary gland type” tumors in the World Health Organization (WHO) classification of lung cancers. It generally carries a better prognosis than the more common small cell and nonsmall cell lung carcinomas. It is pathologically classified into high-grade and low-grade tumors. High-grade tumors are usually unresectable at presentation. However, surgery is the mainstay of treatment, which aims at surgically negative margins for a complete cure. In our patient, pulmonary MEC presented with intrathoracic mass with pericardial effusion. It came out to be low-grade neoplasm, which was treated with platinum-based doublet chemotherapy and responded well with near-total disappearance of tumor, like a vanishing lung tumor.
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Affiliation(s)
- Jyoti Bajpai
- Department of Respiratory Medicine, King George's Medical University, Lucknow, UP, India
| | - T V Rajagopal
- Department of Respiratory Medicine, King George's Medical University, Lucknow, UP, India
| | - Surya Kant
- Department of Respiratory Medicine, King George's Medical University, Lucknow, UP, India
| | - Saumya Shukla
- Department of Pathology, R.M.L. Institute of Medical Sciences, Lucknow, UP, India
| | - Akshyaya Pradhan
- Department of Cardiology, King George's Medical University, Lucknow, UP, India
| | - Darshan K Bajaj
- Department of Respiratory Medicine, King George's Medical University, Lucknow, UP, India
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16
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Kakkar A, Guleria P, Madan K, Kumar R, Kumar S, Jain D. Immunohistochemical Assessment of BAP1 Protein in Mucoepidermoid Carcinomas. Indian J Otolaryngol Head Neck Surg 2019; 71:33-37. [PMID: 30906710 DOI: 10.1007/s12070-018-1549-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 12/04/2018] [Indexed: 11/29/2022] Open
Abstract
Mucoepidermoid carcinomas are common malignant salivary gland tumors. Despite recent advances in diagnosis and treatment, there has not been much improvement in outcome of these patients, necessitating identification of novel targeted therapeutic agents. Genomic profiling of mucoepidermoid carcinomas has recently revealed aberrations in BAP1 gene. Therefore, we conducted this study to identify BAP1 loss by immunohistochemistry in these tumors. Mucoepidermoid carcinoma cases were retrieved; hematoxylin-and-eosin stained sections were reviewed. Immunohistochemistry for BAP1 was performed. Forty cases were assessed, including 25 salivary gland and 15 pulmonary mucoepidermoid carcinomas. There were 19 cases in the parotid (76%), two in submandibular gland (8%), and remaining 16% from minor salivary gland locations. Ten (40%) were low grade, nine (36%) were intermediate grade, and six (24%) were high grade mucoepidermoid carcinomas. Thirteen (86.7%) pulmonary mucoepidermoid carcinomas were tracheobronchial, while two (13.3%) were intraparenchymal; all were low grade mucoepidermoid carcinomas. On immunohistochemistry, BAP1 nuclear staining was retained in all cases (100%), irrespective of tumor location or grade. Therapeutic connotations necessitate the identification of readily applicable techniques to detect BAP1 loss in mucoepidermoid carcinomas. Using immunohistochemistry, loss of BAP1 staining was not seen in any of our cases, suggesting insensitivity of BAP1 IHC to detect aberrations at genomic level in these tumors. Analysis of BAP1 alterations by targeted sequencing may therefore be performed prior to excluding the possibility of response to BAP1-targeted therapeutics based on immunohistochemistry alone.
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Affiliation(s)
- Aanchal Kakkar
- 1Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Prerna Guleria
- 1Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Karan Madan
- 2Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Rajeev Kumar
- 3Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Sunil Kumar
- 4Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Deepali Jain
- 1Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029 India
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Abstract
In recent years, analysis of registry data has defined clinically significant practice patterns and treatment strategies that optimize cancer care for thoracic surgery patients. These higher-order outcome studies rely on large patient cohorts that minimize the risk of selection bias and allow for a powered analysis that is not achievable with single- or multi-institutional data. This review uses recent study examples to highlight important contributions to our knowledge of thoracic surgery and describes how outcomes research using large data can address high impact clinical questions.
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Affiliation(s)
- Benjamin J Resio
- Section of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Andrew P Dhanasopon
- Section of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Justin D Blasberg
- Section of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
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18
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Kumar V, Soni P, Garg M, Goyal A, Meghal T, Kamholz S, Chandra AB. A Comparative Study of Primary Adenoid Cystic and Mucoepidermoid Carcinoma of Lung. Front Oncol 2018; 8:153. [PMID: 29868475 PMCID: PMC5962707 DOI: 10.3389/fonc.2018.00153] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/24/2018] [Indexed: 12/15/2022] Open
Abstract
Background Pulmonary mucoepidermoid carcinoma (PMEC) and pulmonary adenoid cystic carcinoma (PACC) are the two major types of primary salivary gland-type (PSGT) lung cancers. The demographic profile, clinicopathological features, and predictors of survival as an overall group have not been described for PSGT cancers of lung. Methods In this study, we analyzed demographic, clinical, and survival data from 1,032 patients (546 PMEC and 486 PACC) who were diagnosed of PSGT lung cancer in the Surveillance, Epidemiology and End Results database from 1973 to 2014. Results The PSGT constituted 0.09% of all lung cancers with age-adjusted incidence rate of 0.07 per 100,000 person-years and change of −32% from 1973 to 2014. The incidence of PMEC was slightly higher than PACC but there were no differences in the age and sex distribution. PACCs (55%) were significantly higher at trachea and main bronchus while PMECs were more common at peripheral lungs (85%). Most of the tumors were diagnosed at an early stage and were low grade irrespective of histology. As compared to PMEC, significantly higher number of patients with PACC underwent radical surgery and received adjuvant radiation. The 1- and 5-year cause-specific survival was 76.6 and 62.8%, respectively. On multivariate analysis, the survival was affected by age at diagnosis, tumor stage, histological grade, period of diagnosis, and surgical resection. The histology showed strong interaction with time and hazard ratio of patients with PACC was significantly worse than patients with PMEC only after 5 years. Conclusion The incidence of pulmonary PSGT cancer is 7 cases per 10 million population in the United States and is decreasing. There was no difference between demographic profile of patients with PMEC and PACC but pathological features were diverse. The difference in the survival of patients with the two histological types surfaced only after 5 years when survival of patients with PMEC was better than PACC.
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Affiliation(s)
- Vivek Kumar
- Department of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Parita Soni
- Department of Internal Medicine, Maimonides Cancer Center, New York, NY, United States
| | - Mohit Garg
- Department of Internal Medicine, Maimonides Cancer Center, New York, NY, United States
| | - Abhishek Goyal
- Department of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Trishala Meghal
- Department of Hematology and Oncology, Maimonides Cancer Center, New York, NY, United States
| | - Stephan Kamholz
- Department of Internal Medicine, Maimonides Cancer Center, New York, NY, United States
| | - Abhinav Binod Chandra
- Department of Hematology and Oncology, Yuma Regional Medical Center Cancer Center, Yuma, AZ, United States
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Resio BJ, Chiu AS, Hoag J, Dhanasopon AP, Blasberg JD, Boffa DJ. Primary Salivary Type Lung Cancers in the National Cancer Database. Ann Thorac Surg 2018; 105:1633-9. [PMID: 29486180 DOI: 10.1016/j.athoracsur.2018.01.055] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/16/2018] [Accepted: 01/19/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Primary salivary type lung cancers such as adenoid cystic carcinoma (ACC) and mucoepidermoid carcinoma (MEC) are uncommon primary lung tumors that, given their rarity, remain incompletely understood. This study aimed to characterize the management and outcomes associated with these less common pulmonary malignancies. METHODS Patients in the National Cancer Database diagnosed with primary lung and bronchial (not tracheal) MEC and ACC between 2004 and 2014 were identified. Adjusted mortality risk of surgically managed patients was evaluated in multivariable Cox proportional hazards regression models. RESULTS In all, 699 MEC patients and 424 ACC patients were identified. The MEC tumors were smaller (mean size 3.1 cm versus 3.8 cm, p < 0.001), less likely to have lymph node metastases (16% versus 38%, p < 0.001), and less likely to undergo pneumonectomy (9% versus 39%, p < 0.001) compared with ACC. Adjusted Cox models of the surgically managed subset of MEC patients identified high tumor grade (hazard ratio [HR] 3.0, 95% confidence interval [CI]: 1.31 to 7.1, p = 0.01), tumor size greater than 4 cm (HR 6.7, 95% CI: 2.0 to 22.0, p = 0.01), and wedge resection (HR 3.7, 95% CI: 1.1 to 12.0, p = 0.03) to be associated with increased risk of death. For ACC patients, incomplete tumor resection, R1 versus R0 (HR 4.0, 95% CI: 1.5 to 10.6, p = 0.006), and distant metastases (HR 12.6, 95% CI: 2.5 to 64.4, p = 0.002) were associated with increased mortality. CONCLUSIONS Pulmonary MEC and ACC appear to have distinct physical and oncologic attributes in the National Cancer Database. Although the overall prognosis appears to be favorable, there are subsets of primary salivary type lung cancers with increased mortality risk, and efforts should be made to completely resect these tumors.
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Affiliation(s)
- Neda Kalhor
- Department of Pathology, The University of Texas, M D Anderson Cancer Center, Houston, TX, USA
| | - Cesar A. Moran
- Department of Pathology, The University of Texas, M D Anderson Cancer Center, Houston, TX, USA
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Li X, Guo Z, Liu J, Wei S, Ren D, Chen G, Xu S, Chen J. Clinicopathological characteristics and molecular analysis of primary pulmonary mucoepidermoid carcinoma: Case report and literature review. Thorac Cancer 2017; 9:316-323. [PMID: 29388384 PMCID: PMC5792747 DOI: 10.1111/1759-7714.12565] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 10/25/2017] [Accepted: 10/25/2017] [Indexed: 12/28/2022] Open
Abstract
Primary pulmonary mucoepidermoid carcinoma (PMEC) is extremely rare. Herein, we report a case of a 71‐year‐old male patient with high‐grade PMEC involving the right upper lobe that was successfully resected via lobectomy. As a result of invasion into the pleural and paratracheal lymph nodes, four cycles of adjuvant chemotherapy with paclitaxel and carboplatin were administered. There were no signs of relapse during 10 months of follow‐up. Furthermore, we reviewed the literature and summarized the surgical approaches, prognostic factors, and underlying genetic mechanisms of PMEC, which will benefit clinical treatment.
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Affiliation(s)
- Xuanguang Li
- Department of Lung Cancer Surgery, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhibin Guo
- Department of Lung Cancer Surgery, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinghao Liu
- Department of Lung Cancer Surgery, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Sen Wei
- Department of Lung Cancer Surgery, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Dian Ren
- Department of Lung Cancer Surgery, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Gang Chen
- Department of Lung Cancer Surgery, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Song Xu
- Department of Lung Cancer Surgery, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Jun Chen
- Department of Lung Cancer Surgery, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
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