engleski

Mucoepidermoid carcinoma of the lung in a 27 year old woman

Mucoepidermoid carcinoma (MEC) is a rare primary malignancy of the tracheobronchial tree and comprising 0.1-0.2% of primary lung cancers. MEC, the most common malignancy in salivary glands, was earlier thought to occur only in salivary glands. Later studies showed that it can arise as a primary in bronchus, esophagus, lacrimal glands, pancreas, thymus and thyroid gland. The tumor is composed of epithelial cells, mucus secreting cells and cells of an intermediate type identical to those occuring in the salivary glands. There is no standard treatment for these tumours. The prognosis depends on the histological grade and may be poor, particularly in older subjects. We report the case of a 27-year old woman a four months was subfebrile. Chest radiography revealed a mass shadow measuring 50 mm in diameter in the left upper lung field. Chest CT showed a lobulated mass shadow measuring 50 x 27 mm in which there were hypodense zones. The tumor was pressed into the left main bronchus, and it obstructing. No mediastinal lymph node metastasis or other organ metastases were observed. Blood tests showed no abnormal tumor markers. Bronchoscopy revealed tumor obstructing the entry of left B1+2 bronchus. Pathohistological and immunohistochemical findings of tumor forceps biopsy leading to diagnosis of low-grade MEC. Ultrasound findings of major salivary glands in the neck showed no tumor. Patient underwent left upper lobe resection and mediastinal lymphadenectomy. Macroscopic finding showed in the lumen of the main bronchus, well confined, yellowish tumor node a diameter of 35 mm. Histologically, the tumor tissue composed of atypical epithelial cells partly looks of cylindrical cells, occasionally with mucus, and occasionally from some smaller atypical epithelial cells with eosinophilic cytoplasm, oval nuclei and marked nucleoli. In regions with cylindrical epithelial cells were mainly similar lumens glands that are partially filled with mucus. Among the tumor cells was a partly some abundant desmoplastic stroma. Tumor tissue was mainly located in the lumen of the bronchus, and penetrated the wall of the bronchus and entered in the underlying lung tissue. The tumor was not coming to the pleura. In resected lymph nodes was not tumor. Because the postoperative course was good and the tumor was low-grade, no adjuvant treatment was administered. Fifteen months after surgery she gave birth a third son healthy. The patient remains in remission after 34 months follow-up, since resection of the tumor.

mucoepidermoid carcinoma; lung cancer

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