A Rare Case of Pulmonary Mucoepidermoid Carcinoma in an 81-Year-Old Male

Our plain-English summary of A Rare Case of Pulmonary Mucoepidermoid Carcinoma in an 81-Year-Old Male, by M. Abdalla, P. Sinyagovskiy, W. Mohamed, et al (The American Journal of Case Reports, 2018).

The study

• Authors: M. Abdalla, P. Sinyagovskiy, W. Mohamed, A. Abdelghani, B. Al-Azzam
• Journal: The American Journal of Case Reports
• Published: 2018;19:1499-1502
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

BACKGROUND Lung mucoepidermoid carcinoma is a form of non-small cell lung carcinoma that originates from the submucosal glands of the tracheobronchial tree; it is rare and causes 0.1% to 0.2% of lung malignancies. In this article, we report on an occurrence of this condition in an 81-year-old male, which is rare occurrence in this age group. In this case, we found a history of smoking and asbestos exposure which might suggest that exposure to both of these factors can possibly increase the risk for this malignancy. CASE REPORT An 81-year-old male presented with chronic cough and yellow sputum, associated with right upper back pain. The patient was a smoker of 30 packs per year and reported a history of asbestos exposure. He had past medical history of rectal cancer, but no previous history of salivary glands tumors. Physical examination was normal, laboratory investigations were unremarkable. Computed tomography chest showed endobronchial mass with post-obstructive atelectasis. Bronchoscopic evaluation revealed a whitish, endobronchial mass occluding the posterior segment of the right lower lobe. Biopsy showed benign squamous papilloma and malignancy was not excluded as only superficial parts of the mass were obtained. The decision was made to remove the lesion. A right lower lobectomy was done, and histopathology revealed a low grade mucoepidermoid carcinoma; immunohistochemical staining showed tumor cells positive for p40 and p63 supporting the diagnosis. No further adjuvant treatment was recommended, and follow-up imaging was planned for surveillance. CONCLUSIONS Mucoepidermoid carcinoma of the lung is a rare form of non-small cell lung carcinoma. Appropriate diagnosis requires correctly interpreted biopsy results along with immunohistochemical staining results.

In plain English

This case report describes one patient: an 81-year-old man with mucoepidermoid carcinoma of the lung, a rare type of non-small cell lung cancer. He had a chronic cough with yellow sputum and right upper back pain. He was a previous smoker, had worked as a janitor, and reported a history of asbestos exposure. The article gives no details of that exposure, such as fiber type or duration. A chest CT scan and bronchoscopy found a mass blocking part of the right lower lobe. A first biopsy showed a benign papilloma, but cancer could not be ruled out because only the surface of the mass was sampled. After surgery to remove the right lower lobe, tests confirmed a low-grade mucoepidermoid carcinoma, and the lymph nodes were free of tumor. No further treatment was given, and follow-up imaging showed no recurrence. The authors concluded that this case "might suggest" that smoking and asbestos exposure can possibly increase the risk of this cancer. They said more studies are needed to prove such an association.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (a single patient)
• Who was studied: One 81-year-old man with chronic cough, yellow sputum and right upper back pain. The authors are affiliated with a department of internal medicine in Evanston, Illinois, U.S.A. No dates of care are given.
• Exposure: A self-reported history of asbestos exposure, with no fiber type, product, duration or dose given. The patient had worked as a janitor. He was a previous smoker, which the article prints as "30 packs per year".
• Main results:
  • Bronchoscopy found a whitish, hard mass growing inside the airway that completely blocked the posterior segment of the right lower lobe.
  • The first biopsy showed a benign squamous epithelial papilloma. A well-differentiated cancer could not be excluded because only the surface of the mass was sampled.
  • The patient had the right lower lobe of the lung removed, along with lymph nodes.
  • The removed tumor was a low-grade mucoepidermoid carcinoma. Tumor cells stained positive for p40 and p63, which supported the diagnosis.
  • The lymph nodes contained no tumor cells.
  • No further treatment was given, and follow-up imaging showed no recurrence.
  • The authors described age 81 as a very rare age for this cancer to appear.
• The authors' conclusion: The authors concluded that this case might suggest that exposure to smoking and asbestos can possibly increase the risk of this cancer. They also concluded that correct diagnosis requires properly interpreted biopsies together with immunohistochemical staining.
• Limitations the authors state:
  • The authors stated that more studies and case reports are needed to prove the suggested association with smoking and asbestos.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Carcinoma, Asbestos Exposure, Sputum, Atelectasis, Biopsy, Histopathology, Immunohistochemistry.

Related studies

• Asbestos Exposure and Development of Pulmonary Pleomorphic Carcinoma in a Non-smoker: A Rare Non-small Cell Lung Cancer — A.L. Alejo, R.A. Patel, et al. (2023)
• Pulmonary cytopathology of former asbestos workers. Report of the first year — S.D. Greenberg, G.A. Hurst, et al. (1976)
• A rare case of benign multicystic peritoneal mesothelioma misdiagnosed as hydatid cyst found in the liver parenchyma and abdomen cavity of a male with asbestos exposure — A.B. Kelarji, M.S. Alshutaihi, et al. (2021)
• A Rare Case of Malignant Pleural Mesothelioma in a Young Healthy Male Without Asbestos Exposure — S. Khatib, O. Asad, et al. (2021)
• Loss of expression of BAP1 is very rare in non-small cell lung carcinoma — J. Andrici, T.R. Parkhill, et al. (2016)
• Multicystic peritoneal mesothelioma in a 29 year old male — P. Cregan, S. Wiley, et al. (1987)

Browse more research in The American Journal of Case Reports, or return to medical research.