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.	吳一龍, 程穎, 周清, 等. 中國臨床腫瘤學會(CSCO)原發性肺癌診療指南. 北京: 人民衛生出版社, 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. 肺粘液表皮樣癌 1 例. 臨床肺科雜志, 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.	王夢歌, 歐陽松云, 孫培宗, 等. 低度惡性肺粘液表皮樣癌并轉移一例報告并文獻復習. 中國呼吸與危重監護雜志, 2014, 13(4): 409-411.
10.	裴翀, 王麗娜, 查顯奎. 成人支氣管黏液表皮樣癌 1 例. 臨床肺科雜志, 2017, 22(10): 1926-1927.
11.	李紅林, 方進, 鄧達標, 等. 支氣管黏液表皮樣癌 1 例. 中國醫學影像技術, 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.	楊朝暉, 王建軍, 何燕, 等. 肺原發性黏液表皮樣癌的臨床病理研究. 腫瘤學雜志, 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.	王輝, 初向陽, 張連斌, 等. 23 例原發性肺黏液表皮樣癌外科診療及預后分析. 解放軍醫學院學報, 2015, 36(6): 586-589.
23.	陳輝, 余建群, 徐忠孜, 等. 原發性肺粘液表皮樣癌的多排螺旋 CT 表現與病理對照研究. 臨床放射學雜志, 2014, 33(5): 702-706.
24.	江森, 朱曉華, 孫希文, 等. 氣管支氣管樹黏液表皮樣癌的 CT 表現. 中華放射醫學雜志, 2010, 44(1): 20-23.
25.	侯晶晶, 王慧娟, 張國偉, 等. 29 例肺粘液表皮樣癌的臨床分析. 中國肺癌雜志, 2017, 20(3): 168-174.
26.	黃焰, 武春燕, 吳偉, 等. 肺原發黏液表皮樣癌的臨床病理特點及其表皮生長因子受體基因突變情況. 中華病理學雜志, 2016, 45(9): 612-616.
27.	劉彤華. 診斷病理學. 北京: 人民衛生出版社, 2013, 164-165.
28.	師晨陽, 李文才, 李彥鵬, 等. 原發性肺黏液表皮樣癌 64 例臨床病理分析. 鄭州大學學報(醫學版), 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.	黃丙連, 劉瑋, 賴國祥. 肺粘液表皮樣癌的臨床特征及預后影響因素分析. 中國臨床實用醫學, 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.	聶玲, 張孟尼, 龔靜, 等. MECT1-MAML2 融合基因在肺黏液表皮樣癌診斷中的應用. 診斷病理學雜志, 2017, 24(4): 296-298.

1. 吳一龍, 程穎, 周清, 等. 中國臨床腫瘤學會(CSCO)原發性肺癌診療指南. 北京: 人民衛生出版社, 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. 肺粘液表皮樣癌 1 例. 臨床肺科雜志, 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. 王夢歌, 歐陽松云, 孫培宗, 等. 低度惡性肺粘液表皮樣癌并轉移一例報告并文獻復習. 中國呼吸與危重監護雜志, 2014, 13(4): 409-411.
10. 裴翀, 王麗娜, 查顯奎. 成人支氣管黏液表皮樣癌 1 例. 臨床肺科雜志, 2017, 22(10): 1926-1927.
11. 李紅林, 方進, 鄧達標, 等. 支氣管黏液表皮樣癌 1 例. 中國醫學影像技術, 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. 楊朝暉, 王建軍, 何燕, 等. 肺原發性黏液表皮樣癌的臨床病理研究. 腫瘤學雜志, 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. 王輝, 初向陽, 張連斌, 等. 23 例原發性肺黏液表皮樣癌外科診療及預后分析. 解放軍醫學院學報, 2015, 36(6): 586-589.
23. 陳輝, 余建群, 徐忠孜, 等. 原發性肺粘液表皮樣癌的多排螺旋 CT 表現與病理對照研究. 臨床放射學雜志, 2014, 33(5): 702-706.
24. 江森, 朱曉華, 孫希文, 等. 氣管支氣管樹黏液表皮樣癌的 CT 表現. 中華放射醫學雜志, 2010, 44(1): 20-23.
25. 侯晶晶, 王慧娟, 張國偉, 等. 29 例肺粘液表皮樣癌的臨床分析. 中國肺癌雜志, 2017, 20(3): 168-174.
26. 黃焰, 武春燕, 吳偉, 等. 肺原發黏液表皮樣癌的臨床病理特點及其表皮生長因子受體基因突變情況. 中華病理學雜志, 2016, 45(9): 612-616.
27. 劉彤華. 診斷病理學. 北京: 人民衛生出版社, 2013, 164-165.
28. 師晨陽, 李文才, 李彥鵬, 等. 原發性肺黏液表皮樣癌 64 例臨床病理分析. 鄭州大學學報(醫學版), 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. 黃丙連, 劉瑋, 賴國祥. 肺粘液表皮樣癌的臨床特征及預后影響因素分析. 中國臨床實用醫學, 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. 聶玲, 張孟尼, 龔靜, 等. MECT1-MAML2 融合基因在肺黏液表皮樣癌診斷中的應用. 診斷病理學雜志, 2017, 24(4): 296-298.

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