Abstract:
Although mucoepidermoid carcinoma (MEC) is the most diagnosed malignancy of the salivary gland, it rarely localises to the bronchus, accounting for only 0.1-0.2% of all primary lung malignancies. Of those pulmonary MECs, most are found in segmental or lobar bronchi, and they are rarely found in mainstem bronchi, highlighting the novelty of this presentation for thoracic specialists. We present a case report of a seven-year-old female who underwent a carinal resection and a right upper lobectomy for the management of an endobronchial MEC causing right middle lobe (RML) obstruction. Intraoperatively, an exophytic mass originating from the junction of the right main bronchus and bronchus intermedius was identified, causing a partial obstruction of the RML bronchus. Frozen sections demonstrated clear margins and follow-up bronchoscopies have been unremarkable. Given their rarity, endobronchial MECs can be diagnostically difficult and cause uncertainty with respect to their management. Low-grade tumours have a much more favourable prognosis than their high-grade counterparts, with surgical resection being the gold standard of care. Therefore, the index of suspicion, time to diagnosis, and definitive treatment are critical to the outcome.
摘要:
尽管粘液表皮样癌(MEC)是唾液腺最常见的恶性肿瘤,它很少局限于支气管,仅占所有原发性肺部恶性肿瘤的0.1-0.2%。在那些肺MEC中,大多数在节段性或叶性支气管中发现,它们很少在主支气管中发现,突出了这个演讲的新颖性为胸科专家。我们提供了一例7岁女性的病例报告,该女性接受了隆突切除术和右上叶切除术,以治疗引起右中叶(RML)阻塞的支气管内MEC。术中,确定了源自右主支气管和中间支气管交界处的外生肿块,导致RML支气管部分阻塞.冰冻切片显示出清晰的边缘,随访支气管镜检查并不明显。鉴于它们的稀有性,支气管内MECs可能在诊断上很困难,并导致其管理方面的不确定性。低度肿瘤比高度肿瘤有更有利的预后,手术切除是护理的黄金标准。因此,怀疑指数,诊断时间到了,最终的治疗对结果至关重要。