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. 2013 Aug 7;19(1):62-4.
doi: 10.1016/j.rpor.2013.07.004. eCollection 2014 Jan.

Mucoepidermoid carcinoma of lung masquerading as urothelial carcinoma of bladder

Donna M Graham  1 , Kate M O'Connor  2 , John Hinchion  3 , Linda E Coate  4 , Louise Burke  2 , Derek G Power  1
Affiliations

Mucoepidermoid carcinoma of lung masquerading as urothelial carcinoma of bladder

Donna M Graham et al. Rep Pract Oncol Radiother. .

Abstract

Background: Mucoepidermoid carcinoma (MEC) of the lung is a rare subtype of non-small cell lung cancer. There is no consensus regarding optimal management for this disease.

Case report: We present a case of MEC of the lung in a 75 year-old female with a history of superficial urothelial carcinoma of the bladder. The patient was found to have an asymptomatic lung mass. Initial biopsy suggested metastatic recurrence of urothelial carcinoma and therefore, cisplatin and gemcitabine chemotherapy was administered prior to surgical resection. Pathological analysis of the resected specimen confirmed a diagnosis of stage IIIA MEC with focal high-grade features including transitional cell-like areas. Adjuvant radiotherapy was administered due to a positive microscopic resection margin. No chemotherapy was given due to lack of supporting data. The patient developed widespread metastatic disease 3 months following completion of radiotherapy and died 1 month later.

Conclusion: This case demonstrates the possibility of dual pathology in cases where metastatic disease is suspected. The use of small tissue samples may complicate diagnosis due to the heterogeneity of malignant tumours.

Keywords: Adequate tissue; Dual pathology; Mucoepidermoid carcinoma.

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Figures

Fig. 1
Fig. 1
Biopsy sample (high power 20×) demonstrated fibrotic tissue incorporating islands of monomorphic cells with plentiful eosinophilic cytoplasm. An occasional mitotic and apoptotic figure was identified. Immunohistochemical staining was positive for CK7, CK20 and AE1/3 and negative for TTF-1, suggesting urothelial carcinoma.
Fig. 2
Fig. 2
Resection specimen. H&E staining of tumour showing (a) areas of clear cells and glandular areas embedded within fibrous stroma, (b) PAS-D stain highlights cellular mucin in the glandular spaces and in lesional cells consistent with mucoepidermoid carcinoma and (c) transitional cell-like areas similar to the initial biopsy.
See this image and copyright information in PMC

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