(CR25) Mucoepidermoid Carcinoma - A Rare Primary Tracheobronchial Tumor in Children

Introduction:

Primary pulmonary cancers in children are extremely rare. Mucoepidermoid carcinoma (MEC) of the lung is a rare form of lung cancer with incidence of 0.1 to 0.2%. The clinical symptoms of pulmonary MEC include cough and hemoptysis that resembles infective changes. It is classified into low grade and high grade histologically with varied treatment regime. 

Case Presentation:

We report a case study of a 12-year-old boy presented with chesty cough and dyspnea since 6months associated with hemoptysis for 3 days. Chest radiograph demonstrated increased retrocardiac density suggestive of left lower lobe collapse. Contrast enhanced CT Thorax was planned thereafter which revealed a large lobulated mass at the left hilum compressing the left main bronchus causing left lower lobe collapse. Patient underwent left lower lobe sleeve resection with intra-operative findings of mass in the left main bronchus and left lower lobe. Endobronchial luminal mass was removed along with hilar lymph node excision and subsequent primary anastomosis of left main bronchus and left upper lobe bronchus. A histopathological interpretation of a low-grade endobronchial MEC was made without lymph node metastasis. Post operatively, child recovered well and allowed for discharge.

Conclusion :

Pulmonary MECs are typically endobronchial arising in the lobar or segmental bronchi. Complete surgical resection is the optimal treatment for low-grade tumors with excellent prognosis whilst adjunct therapy such as radiotherapy and chemotherapy are reserved for high-grade cases. A high index of suspicion is imperative for diagnosis of pulmonary MEC in cases mimicking lung tumor and non-responsive to antibiotic therapy.