A Case of Mucoepidermoid Carcinoma of the Lung with Massive Mucoid Impaction

Abstract

Background. Mucoepidermoid carcinoma is a rare pulmonary tumor, and reports on mucoepidermoid carcinoma of the lung with massive mucoid impaction are limited. Case. A 27-year-old woman with a chief complaint of left chest pain and productive cough was diagnosed with pneumonia. When she failed to improve on antibiotics, chest computed tomography (CT) was performed, which showed complete obstruction of the left main bronchus and a tumor at the proximal aspect of the left lower lobe bronchus. The patient was then referred to our hospital. A bronchoscopic examination revealed viscous mucous obstructing the left main bronchus. We were thus unable to obtain a tumor specimen and make a diagnosis by a biopsy. On our second attempt at bronchoscopy, using a frozen section diagnosis, we were able to obtain adequate samples and pathologically make the diagnosis of mucoepidermoid carcinoma, stage IB (cT2aN0M0). Because the tumor was located at the opening of the left lower lobe bronchus, left pneumonectomy was considered. However, lobectomy with bronchoplasty was able to achieve complete resection of the tumor, thus sparing the upper lobe. Conclusion. Bronchoscopy with a frozen section diagnosis may be useful for diagnosing mucoepidermoid carcinoma with massive mucoid impaction. Furthermore, lung-sparing surgery may be an option in cases of mucoepidermoid carcinoma.