Akkawi Amna, Adas Abdulkarim, Abdul-Hafez Hamza A, Daragmeh Laith, Barakat Mohammed A, Abulihya Mohanad
Department of General Surgery, An-Najah National University Hospital, Nablus, Palestine; Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
Department of Cardiothoracic Surgery, An-Najah National University Hospital, Nablus, Palestine.
Int J Surg Case Rep. 2025 Jan;126:110775. doi: 10.1016/j.ijscr.2024.110775. Epub 2024 Dec 24.
Pulmonary mucoepidermoid carcinoma (PMEC) is a rare lung tumor, accounting 0.1-0.2 % of lung malignancies, commonly affecting adults under 50. PMEC arises from salivary gland tissue within the lung and can resemble other lung cancers, which challenging the diagnosis.
A 50-year-old woman with asthma presented with increased cough and abdominal pain. An incidental lung mass on CT was confirmed as low-grade PMEC. She underwent right lower lobectomy via video-assisted thoracoscopy (VATS), complicated by a pulmonary embolism, which was managed successfully. Follow-up imaging revealed a new nodule, later found to be benign.
Despite of its rarity, PMEC should be considered in patients with respiratory symptoms, especially in unsuccsisful treatments, such as asthma management. PMEC's central location can lead to misdiagnosis as non-small cell lung cancer, but immunohistochemistry and histopathology are key for accurate differentiation. VATS is the preferred surgical approach for resectable PMEC, providing benefits of reduced recovery time and complications compared to open surgery. While low-grade PMEC has a generally favorable prognosis, cases like this highlight the importance of follow-up, as recurrence or new lesions can emerge post-resection, necessitating vigilant monitoring.
This case highlights the diagnostic and management challenges of PMEC, underscoring the importance of incidental findings, tailored surgical approaches, and proactive follow-up.
肺黏液表皮样癌(PMEC)是一种罕见的肺部肿瘤,占肺恶性肿瘤的0.1 - 0.2%,常见于50岁以下成年人。PMEC起源于肺内的唾液腺组织,可能与其他肺癌相似,这对诊断构成挑战。
一名患有哮喘的50岁女性出现咳嗽加重和腹痛。CT检查偶然发现肺部肿块,确诊为低级别PMEC。她通过电视辅助胸腔镜手术(VATS)进行了右下肺叶切除术,术后并发肺栓塞,但成功得到处理。随访影像显示有一个新结节,后来发现是良性的。
尽管PMEC罕见,但对于有呼吸道症状的患者,尤其是在治疗效果不佳(如哮喘管理)的情况下,应考虑到该病。PMEC的中心位置可能导致误诊为非小细胞肺癌,但免疫组化和组织病理学是准确鉴别诊断的关键。VATS是可切除PMEC的首选手术方法,与开放手术相比,具有恢复时间短和并发症少的优点。虽然低级别PMEC总体预后良好,但此类病例凸显了随访的重要性,因为切除术后可能出现复发或新病变,需要进行密切监测。
本病例突出了PMEC在诊断和管理方面的挑战,强调了偶然发现、个性化手术方法以及积极随访的重要性。