Mucoepidermoid Carcinoma of the Trachea and Bronchus: The Case for Conservative Resection

doi:10.1016/S0003-4975(10)61867-X

The Annals of Thoracic Surgery

Volume 29, Issue 3, March 1980, Pages 197-204

https://doi.org/10.1016/S0003-4975(10)61867-X Get rights and content

Abstract

We report our experience with 5 patients with mucoepidermoid carcinoma treated by conservative resection, and review the literature on the 62 patients previously reported. A visual bron-choscopic diagnosis of adenoma was made in all 5 current patients. Bronchoscopic biopsy was performed in 4 and provided an accurate histological diagnosis in each. Conservative resection was accomplished with bronchoplastic techniques in 4 patients: sleeve lobectomy, 2; lobectomy with plastic bronchial closure, 1; and segmental tracheal resection, 1. The other patient underwent conventional lobectomy. All 5 patients are alive and free from disease 4 to 15 years following operation.

The recently demonstrated correlation between histological grading and clinical behavior allows relatively benign variants of mucoepidermoid tumors to be accurately identified by bronchoscopic biopsy prior to thoracotomy. Because these tumors have a propensity to originate centrally in the tracheobronchial tree, bronchoplastic procedures frequently are required in order to accomplish tumor extirpation with limited pulmonary resection.

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Les tumeurs muco-épidermoïdes (TME) sont des tumeurs rares développées au niveau des glandes séro-muqueuses péri-bronchiques. Certaines de ces tumeurs évoluent comme des tumeurs malignes. Parmi celles-ci, beaucoup ont été probablement confondues avec des cancers bronchiques adénosquameux.
Nous avons revu 22 patients porteurs de TME observés en 25 ans. Deux de ces tumeurs étaient de siège trachéal ; les 20 autres tumeurs siégeaient au niveau de l’arbre bronchique cartilagineux. Douze de ces TME avaient des critères macroscopiques et histologiques de bas grade de malignité, 4 avaient des critères macroscopiques et 6 des critères macroscopiques et microscopiques de haut grade de malignité.
Les tumeurs muco-épidermoïdes de haut grade de malignité étaient de mauvais pronostic avec aucune survie au-delà de 6 ans ; ce comportement les rapproche des carcinomes bronchiques « classiques », et notamment des carcinomes adénosquameux.
Le meilleur traitement de cette maladie orpheline reste la chirurgie.
Mucoepidermoid tumours (TME) are rare tumours arising from the submucosal glands of the tracheobronchial tree. The majority of these tumours develop in a benign fashion but some of them are malignant. The latter can be easily mistaken for adenosquamous carcinomas.
We have reviewed 22 patients suffering from TME observed over a period of 25 years. Two arose from the trachea and 20 from the cartilaginous bronchi; 12 of these tumours had macroscopic and histological criteria of low-grade malignancy, 4 had macroscopic and 6 macroscopic and microscopic criteria of high grade malignancy.
Prognosis of the latter was very poor and no survival observed after 6 years follow-up, a behavior similar to that observed in non-small cell lung carcinomas and adenosquamous carcinomas.
The best treatment of these orphan tumours remains surgery.
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Mucoepidermoid cancers are rare tumors that arise from the serous and mucous glands of the upper airway and salivary glands. Patients, especially children, with tumors that arise in the trachea and upper airways are often misdiagnosed as asthmatic and are treated with bronchodilators without resolution. A 7-year-old girl who had been diagnosed as asthmatic was subsequently found to have a mucoepidermoid tumor of the trachea. She underwent a successful tracheal resection and remains tumor free on follow-up bronchoscopy at 16 months.
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Mucoepidermoid Carcinoma of the Trachea and Bronchus: The Case for Conservative Resection

Abstract

J Thorac Cardiovasc Surg

J Thorac Carciovasc Surg

J Thorac Cardiovasc Surg

J Thorac Cardiovasc Surg

J Thorac Cardiovasc Surg

J Thorac Cardiovasc Surg

J Thorac Cardiovasc Surg

Chest

Ann Thorac Surg