Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
Thorac Cancer. 2023 May;14(14):1306-1310. doi: 10.1111/1759-7714.14861. Epub 2023 Mar 16.
Mucoepidermoid carcinoma (MEC) is a rare salivary gland tumor, accounting for 0.2% of all lung tumors. The standard treatment for MEC of the primary bronchus is surgery, although intraluminal bronchoscopic treatment has recently become an option. A 68-year-old man presented with an asymptomatic bronchial tumor in the right intermediate bronchus. The tumor was resected using a high-frequency snare (HFS) during bronchoscopy, and the specimen was pathologically diagnosed as low-grade MEC. A residual lesion was detected in the resected area by autofluorescence imaging. The tumor appeared to be localized within the subepithelial layer without metastases, and photodynamic therapy (PDT) was performed as a local treatment. The patient had no recurrence for 18 months. PDT is effective and safe for patients with centrally located early-stage lung cancer, but there are few reports of its use for rare tumors, such as MEC. In this case, PDT allowed for local control and avoided surgery, including bronchoplasty, for MEC. Combined treatment of tumor reduction by HFS and PDT of the residual lesion may be an optimal treatment for MEC of the bronchus.
黏液表皮样癌(MEC)是一种罕见的唾液腺肿瘤,占所有肺部肿瘤的 0.2%。原发性支气管 MEC 的标准治疗方法是手术,尽管最近腔内支气管镜治疗已成为一种选择。一名 68 岁男性因右中间支气管的无症状支气管肿瘤就诊。在支气管镜下使用高频圈套器(HFS)切除肿瘤,标本病理诊断为低级别 MEC。在切除区域通过自体荧光成像检测到残留病变。肿瘤似乎局限于黏膜下层,无转移,进行光动力治疗(PDT)作为局部治疗。患者 18 个月无复发。PDT 对中央型早期肺癌患者有效且安全,但对于 MEC 等罕见肿瘤的应用报道较少。在该病例中,PDT 实现了局部控制,避免了对 MEC 的手术治疗,包括支气管成形术。HFS 减少肿瘤和 PDT 治疗残留病变的联合治疗可能是支气管 MEC 的最佳治疗方法。