Pulmonary mucoepidermoid carcinoma: a case report and review of the literature_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

SUN Ling ¹ , YE Yuchao ¹ , YANG Hua ² , ZHOU Liang ¹ ,  HUANG Bo ¹

1. The Second Department of Respiratory Medicine, Affliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563003, P. R. China;
2. Pathology Department, Affliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563003, P. R. China;

Corresponding author：

HUANG Bo, Email: 13985229382@139.com

Keywords：

Lung neoplasms; Mucoepidermoid carcinoma; Clinical features; Treatment; Prognosis

DOI：

10.7507/1671-6205.201805043

Video：

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ObjectiveTo summarize the clinical features of pulmonary mucoepidermoid carcinoma (PMEC) and improve the level of the diagnosis and therapy.MethodsA case of PMEC was reported and related literatures were reviewed in PubMed, WanFang data and China National Knowledge Infrastructure.ResultsA 21-year-old female patient, complaining of cough and expectoration for 5 months, intermittent hemoptysis for 3 months and repeated fever more than 4 days, was hospitalized in March 2017. After admission, the patient was diagnosed as low-grade PMEC and received anti-infection, fibrobronchoscope sputum aspiration and alveolar lavage therapy. During the hospitalization, the anti-infection of the patients was not much effective, and the chest CT examination suggested space-occupying lesions in the middle lobe of the right lung. After the surgical removal of the right lung, the syndrome of the patient was improved. A total of 13 patients were reviewed, there was no obvious gender difference, and the median age was about 40 years old (most frequently occurred in younger adults with an average age less than 50 years). Frequent clinical manifestations were cough, fever and hemoptysis, which were often accompanied with atelectasis. Most of the patients could be improved after surgical resection, and a few need comprehensive treatment including radiotherapy, chemotherapy and targeted treatment, etc.ConclusionsPMEC is rare and the etiology is still unclear. The pathology is mainly low-grade. Majority of patients with PMEC could be cured after surgical resection.

Citation： SUN Ling, YE Yuchao, YANG Hua, ZHOU Liang, HUANG Bo. Pulmonary mucoepidermoid carcinoma: a case report and review of the literature. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(6): 599-603. doi: 10.7507/1671-6205.201805043 Copy

1.	吴一龙, 程颖, 周清, 等. 中国临床肿瘤学会(CSCO)原发性肺癌诊疗指南. 北京: 人民卫生出版社, 2017, 87-88.
2.	Qian X, Sun Z, Pan W, et al. Childhood bronchial mucoepidermoid tumors: a case report and literature review. Oncol Lett, 2013, 6(5): 1409-1412.
3.	于琳, 堂吉斯. 肺粘液表皮样癌 1 例. 临床肺科杂志, 2017, 22(9): 1741-1743.
4.	Li X, Guo Z, Liu J, et al. Clinicopathological characteristics and molecular analysis of primary pulmonary mucoepidermoid carcinoma: case report and literature review. Thoracic Cancer, 2017, 9(2): 316-323.
5.	Omesh T, Gupta R, Saqi A, et al . A rare case of endobronchial mucoepidermoid carcinoma of the lung presenting as non-resolving pneumonia. Respir Med Case Rep, 2018, 25: 154-157.
6.	Al-Halawani M, Abdeen Y. Mucoepidermoid carcinoma of the trachea. Quant Imaging Med Surg, 2018, 8(2): 259-260.
7.	Horst M, Dekker M, Braak S. Mucoepidermoid carcinoma of the airways in a young adult male. J Radiol Case Rep, 2017, 11(2): 8-15.
8.	Franco I, Tente D, Coutinho D, et al. Single symptomatic colonic metastasis as first presentation of a pulmonary mucoepidermoid carcinoma. Clin Respir J, 2016, 10(4): 524-529.
9.	王梦歌, 欧阳松云, 孙培宗, 等. 低度恶性肺粘液表皮样癌并转移一例报告并文献复习. 中国呼吸与危重监护杂志, 2014, 13(4): 409-411.
10.	裴翀, 王丽娜, 查显奎. 成人支气管黏液表皮样癌 1 例. 临床肺科杂志, 2017, 22(10): 1926-1927.
11.	李红林, 方进, 邓达标, 等. 支气管黏液表皮样癌 1 例. 中国医学影像技术, 2016, 32(9): 1469.
12.	Li SM, Zhang Z, Tang H, et al. Pathological complete response to gefitinib in a 10-year-old boy with EGFR-negative pulmonary mucoepidermoid carcinoma: a case report and literature review. Clin Respir J, 2017, 11(3): 346-351.
13.	Fink DD, Lomas AM, Roden AC, et al. Primary mucoepidermoid carcinoma of the lung with prominent clear cells. Proc (Bayl Univ Med Cent), 2017, 30(3): 322-324.
14.	Alsidawi S, Morris JC, Wikenheiser-Brokamp KA, et al. Mucoepidermoid carcinoma of the lung: a case report and literature review. Case Rep Oncol Med, 2013: 625243.
15.	杨朝晖, 王建军, 何燕, 等. 肺原发性黏液表皮样癌的临床病理研究. 肿瘤学杂志, 2015, 21(8): 640-644.
16.	Hayashi I, Muto Y, Fujii Y, et al. Mucoepidermoid carcinoma of the stomach. J Surg Oncol, 1987, 34(2): 94-99.
17.	Choi D, Kim H, Lee KS, et al. Mucoepidermoid carcinoma of the liver diagnosed as a liver abscess: report of a case. Surg Today, 2004, 34(11): 968-972.
18.	Han F, Jiang H, Zhang S. Mucoepidermoid carcinoma of the transverse colon: a rare tumor entity with literature review. Pathol Int, 2017, 67(7): 361-364.
19.	Jiang L, Li P, Xiao Z, et al. Prognostic factors of primary pulmonary mucoepidermoid carcinoma: a clinical and pathological analysis of 34 cases. Int J Clin Exp Pathol, 2014, 7(10): 6792-6799.
20.	Hsieh CC, Sun YH, Lin SW, et al. Surgical outcomes of pulmonary mucoepidermoid carcinoma: a review of 41 cases. PLoS One, 2017, 12(5): e0176918.
21.	Wang YQ, Mo YX, Li S, et al. Low-grade and high-grade mucoepidermoid carcinoma of the lung: CT findings and clinical features of 17 cases. Am J Roentgenol, 2015, 205(6): 1160-1166.
22.	王辉, 初向阳, 张连斌, 等. 23 例原发性肺黏液表皮样癌外科诊疗及预后分析. 解放军医学院学报, 2015, 36(6): 586-589.
23.	陈辉, 余建群, 徐忠孜, 等. 原发性肺粘液表皮样癌的多排螺旋 CT 表现与病理对照研究. 临床放射学杂志, 2014, 33(5): 702-706.
24.	江森, 朱晓华, 孙希文, 等. 气管支气管树黏液表皮样癌的 CT 表现. 中华放射医学杂志, 2010, 44(1): 20-23.
25.	侯晶晶, 王慧娟, 张国伟, 等. 29 例肺粘液表皮样癌的临床分析. 中国肺癌杂志, 2017, 20(3): 168-174.
26.	黄焰, 武春燕, 吴伟, 等. 肺原发黏液表皮样癌的临床病理特点及其表皮生长因子受体基因突变情况. 中华病理学杂志, 2016, 45(9): 612-616.
27.	刘彤华. 诊断病理学. 北京: 人民卫生出版社, 2013, 164-165.
28.	师晨阳, 李文才, 李彦鹏, 等. 原发性肺黏液表皮样癌 64 例临床病理分析. 郑州大学学报(医学版), 2017, 52(1): 92-95.
29.	Huo Z, Wu H, Li J, et al. Primary pulmonary mucoepidermoid carcinoma: histopathological and moleculargenetic studies of 26 cases. PLoS One, 2015, 10(11): e0143169.
30.	Yamatani C, Abe M, Shimoji M, et al. Pulmonary adenosquamous carcinoma with mucoepidermoid carcinoma-like component with characteristic p63 staining pattern: either a novel subtype originating from bronchial epithelium or variant mucoepidermoid carcinoma. Lung Cancer, 2014, 84(1): 45-50.
31.	Clauditz TS, Gontarewicz A, Wang CJ, et al. 11q21 rearrangement is a frequent and highly specific genetic alteration in mucoepidermoid carcinoma. Diagn Mol Pathol, 2012, 21(3): 134-137.
32.	黄丙连, 刘玮, 赖国祥. 肺粘液表皮样癌的临床特征及预后影响因素分析. 中国临床实用医学, 2016, 7(5): 12-16.
33.	Tamaki T, Tanijiri T, Katashiba Y, et al. A case of lung mucoepidermoid carcinoma with EGFR mutation successfully treated by gefitinib. Haigan, 2010, 50(1): 27-32.
34.	Xi JJ, Jiang W, Lu SH, et al. Primary pulmonary mucoepidermoid carcinoma: an analysis of 21 cases. World J Surg Oncol, 2012, 10: 232.
35.	Seethala RR, Dacic S, Cieply K, et al. A reappraisal of the MECT1 /MAML2 translocation in salivary mucoepidermoid carcinomas. Am J Surg Pathol, 2010, 34(8): 1106-1121.
36.	聂玲, 张孟尼, 龚静, 等. MECT1-MAML2 融合基因在肺黏液表皮样癌诊断中的应用. 诊断病理学杂志, 2017, 24(4): 296-298.

1. 吴一龙, 程颖, 周清, 等. 中国临床肿瘤学会(CSCO)原发性肺癌诊疗指南. 北京: 人民卫生出版社, 2017, 87-88.
2. Qian X, Sun Z, Pan W, et al. Childhood bronchial mucoepidermoid tumors: a case report and literature review. Oncol Lett, 2013, 6(5): 1409-1412.
3. 于琳, 堂吉斯. 肺粘液表皮样癌 1 例. 临床肺科杂志, 2017, 22(9): 1741-1743.
4. Li X, Guo Z, Liu J, et al. Clinicopathological characteristics and molecular analysis of primary pulmonary mucoepidermoid carcinoma: case report and literature review. Thoracic Cancer, 2017, 9(2): 316-323.
5. Omesh T, Gupta R, Saqi A, et al . A rare case of endobronchial mucoepidermoid carcinoma of the lung presenting as non-resolving pneumonia. Respir Med Case Rep, 2018, 25: 154-157.
6. Al-Halawani M, Abdeen Y. Mucoepidermoid carcinoma of the trachea. Quant Imaging Med Surg, 2018, 8(2): 259-260.
7. Horst M, Dekker M, Braak S. Mucoepidermoid carcinoma of the airways in a young adult male. J Radiol Case Rep, 2017, 11(2): 8-15.
8. Franco I, Tente D, Coutinho D, et al. Single symptomatic colonic metastasis as first presentation of a pulmonary mucoepidermoid carcinoma. Clin Respir J, 2016, 10(4): 524-529.
9. 王梦歌, 欧阳松云, 孙培宗, 等. 低度恶性肺粘液表皮样癌并转移一例报告并文献复习. 中国呼吸与危重监护杂志, 2014, 13(4): 409-411.
10. 裴翀, 王丽娜, 查显奎. 成人支气管黏液表皮样癌 1 例. 临床肺科杂志, 2017, 22(10): 1926-1927.
11. 李红林, 方进, 邓达标, 等. 支气管黏液表皮样癌 1 例. 中国医学影像技术, 2016, 32(9): 1469.
12. Li SM, Zhang Z, Tang H, et al. Pathological complete response to gefitinib in a 10-year-old boy with EGFR-negative pulmonary mucoepidermoid carcinoma: a case report and literature review. Clin Respir J, 2017, 11(3): 346-351.
13. Fink DD, Lomas AM, Roden AC, et al. Primary mucoepidermoid carcinoma of the lung with prominent clear cells. Proc (Bayl Univ Med Cent), 2017, 30(3): 322-324.
14. Alsidawi S, Morris JC, Wikenheiser-Brokamp KA, et al. Mucoepidermoid carcinoma of the lung: a case report and literature review. Case Rep Oncol Med, 2013: 625243.
15. 杨朝晖, 王建军, 何燕, 等. 肺原发性黏液表皮样癌的临床病理研究. 肿瘤学杂志, 2015, 21(8): 640-644.
16. Hayashi I, Muto Y, Fujii Y, et al. Mucoepidermoid carcinoma of the stomach. J Surg Oncol, 1987, 34(2): 94-99.
17. Choi D, Kim H, Lee KS, et al. Mucoepidermoid carcinoma of the liver diagnosed as a liver abscess: report of a case. Surg Today, 2004, 34(11): 968-972.
18. Han F, Jiang H, Zhang S. Mucoepidermoid carcinoma of the transverse colon: a rare tumor entity with literature review. Pathol Int, 2017, 67(7): 361-364.
19. Jiang L, Li P, Xiao Z, et al. Prognostic factors of primary pulmonary mucoepidermoid carcinoma: a clinical and pathological analysis of 34 cases. Int J Clin Exp Pathol, 2014, 7(10): 6792-6799.
20. Hsieh CC, Sun YH, Lin SW, et al. Surgical outcomes of pulmonary mucoepidermoid carcinoma: a review of 41 cases. PLoS One, 2017, 12(5): e0176918.
21. Wang YQ, Mo YX, Li S, et al. Low-grade and high-grade mucoepidermoid carcinoma of the lung: CT findings and clinical features of 17 cases. Am J Roentgenol, 2015, 205(6): 1160-1166.
22. 王辉, 初向阳, 张连斌, 等. 23 例原发性肺黏液表皮样癌外科诊疗及预后分析. 解放军医学院学报, 2015, 36(6): 586-589.
23. 陈辉, 余建群, 徐忠孜, 等. 原发性肺粘液表皮样癌的多排螺旋 CT 表现与病理对照研究. 临床放射学杂志, 2014, 33(5): 702-706.
24. 江森, 朱晓华, 孙希文, 等. 气管支气管树黏液表皮样癌的 CT 表现. 中华放射医学杂志, 2010, 44(1): 20-23.
25. 侯晶晶, 王慧娟, 张国伟, 等. 29 例肺粘液表皮样癌的临床分析. 中国肺癌杂志, 2017, 20(3): 168-174.
26. 黄焰, 武春燕, 吴伟, 等. 肺原发黏液表皮样癌的临床病理特点及其表皮生长因子受体基因突变情况. 中华病理学杂志, 2016, 45(9): 612-616.
27. 刘彤华. 诊断病理学. 北京: 人民卫生出版社, 2013, 164-165.
28. 师晨阳, 李文才, 李彦鹏, 等. 原发性肺黏液表皮样癌 64 例临床病理分析. 郑州大学学报(医学版), 2017, 52(1): 92-95.
29. Huo Z, Wu H, Li J, et al. Primary pulmonary mucoepidermoid carcinoma: histopathological and moleculargenetic studies of 26 cases. PLoS One, 2015, 10(11): e0143169.
30. Yamatani C, Abe M, Shimoji M, et al. Pulmonary adenosquamous carcinoma with mucoepidermoid carcinoma-like component with characteristic p63 staining pattern: either a novel subtype originating from bronchial epithelium or variant mucoepidermoid carcinoma. Lung Cancer, 2014, 84(1): 45-50.
31. Clauditz TS, Gontarewicz A, Wang CJ, et al. 11q21 rearrangement is a frequent and highly specific genetic alteration in mucoepidermoid carcinoma. Diagn Mol Pathol, 2012, 21(3): 134-137.
32. 黄丙连, 刘玮, 赖国祥. 肺粘液表皮样癌的临床特征及预后影响因素分析. 中国临床实用医学, 2016, 7(5): 12-16.
33. Tamaki T, Tanijiri T, Katashiba Y, et al. A case of lung mucoepidermoid carcinoma with EGFR mutation successfully treated by gefitinib. Haigan, 2010, 50(1): 27-32.
34. Xi JJ, Jiang W, Lu SH, et al. Primary pulmonary mucoepidermoid carcinoma: an analysis of 21 cases. World J Surg Oncol, 2012, 10: 232.
35. Seethala RR, Dacic S, Cieply K, et al. A reappraisal of the MECT1 /MAML2 translocation in salivary mucoepidermoid carcinomas. Am J Surg Pathol, 2010, 34(8): 1106-1121.
36. 聂玲, 张孟尼, 龚静, 等. MECT1-MAML2 融合基因在肺黏液表皮样癌诊断中的应用. 诊断病理学杂志, 2017, 24(4): 296-298.

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