Endobronchial mucoepidermoid carcinoma in a pediatric patient: A case report

Abstract

Mucoepidermoid carcinoma (MEC) is an uncommon type of salivary gland tumor that can present as an endobronchial neoplasm, most commonly in the adult population. Neuroendocrine carcinoid tumors comprise the majority of bronchial neoplasms in the pediatric population and are nearly indistinguishable from MEC on imaging. We present a rare case of MEC in a 3-year-old presenting with recurrent symptoms of lower airway obstruction and discuss its typical associated symptoms and imaging features.

Keywords: Endobronchial tumor; Mucoepidermoid carcinoma; Pediatric; Pediatric radiology.

Fig. 1

Sequential frontal chest radiographs approximately (A) 2 weeks, (B) 6 weeks, and (C) 2 months from initial symptoms show a relatively unchanged right middle and lower lobe consolidation over the course of 2 months.

Fig. 2

Axial, coronal, and sagittal CT images with lung and soft tissue windows demonstrate (A, B) a 9 mm mildly enhancing, exophytic endobronchial mass arising from the right bronchus intermedius (red arrows). (C, D) Postobstructive consolidation and bronchiectasis (blue arrows) are present along with (E, F) associated air trapping evidenced by scattered areas of hyperlucent lung parenchyma (green arrows) (Color version of figure is available online).

Fig. 3

Bronchoscopic images in the (A) right mainstem bronchus and (B) bronchus intermedius demonstrate an obstructive mass (red arrow) just distal to the patent right upper lobe bronchus (blue arrow) (Color version of figure is available online).

Fig. 4

H&E-stained section at 10× magnification of whole 9 mm infiltrative mucosal tumor (arrow) composed of islands and cords of intermediate cells and mucin producing cells, expanding the underlying lamina propria (arrowhead). Tumor extended to the mucosal and deep margins. No bronchial muscle or cartilage was present. At 40× magnification superficial mucosal involvement is appreciated (*) with invasive tumor underneath.