Primary mucoepidermoid carcinoma at the carina of trachea presenting with wheezing in an asthmatic child mimicking an attack of asthma

Lin, Chien Heng; Chao, Yu Hua; Wu, Kang; Lin, Wen Han

doi:10.1097/md.0000000000005292

Cited by 6 publications

(6 citation statements)

References 17 publications

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“…The presence of wheezing may lead to misdiagnosis of asthma as in our patient. Previous reported cases have shown that MEC can mimics asthmatic symptoms even in children and may also be misdiagnosed as invasive thyroid cancer 5 6…”

Section: Discussionmentioning

confidence: 99%

Resolution of asthmatic symptoms following successful endoscopic resection of tracheal mucoepidermoid carcinoma

et al. 2019

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Mucoepidermoid carcinoma (MEC) is a rare tumour of the trachea accounting for up to 0.2% of reported primary lung malignancy. We report a case of a 54-year-old man, ex-smoker, whose presentation mimicked adult onset asthma with cough and wheezing, which did not respond to conventional treatment. He had occasional haemoptysis and weight loss in which CT scan performed for malignancy screening showed a protruding mass in the distal trachea causing endobronchial obstruction. Bronchoscopic intervention was performed to relieve the obstruction that resulted in resolution of asthmatic symptoms. Histological diagnosis confirmed MEC. This case emphasised the importance of a high index of suspicion in an unusual presentation of a common disease and the pivotal role of bronchoscopic intervention in malignant central airway obstruction.

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Section: Discussionmentioning

confidence: 99%

Resolution of asthmatic symptoms following successful endoscopic resection of tracheal mucoepidermoid carcinoma

et al. 2019

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“…There was no seasonal variation. In view of overlapping specific symptoms patient was earlier diagnosed as case of asthma and took treatment for the same but to no relief [ 4 ].…”

Section: Case Reportmentioning

confidence: 99%

Mucoepidermoid carcinoma of the trachea in a 9-year-old male child: case report and review of literature

et al. 2022

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Mucoepidermoid carcinoma (MEC) is most common malignancy of minor salivary glands in adults. Pulmonary MEC is extremely uncommon comprising of only 0.1%–0.2% of the primary lung malignancies and <1% of primary bronchial tumors. It is even rarer in children and literature limited to few case reports only. Here we present a case report of a 9-year-old boy diagnosed with primary MEC of trachea along with review of the literature. A 9-year-old male child presented with complaint of dry cough for two years which was later associated with shortness of breath after one year. Bronchoscopic examination revealed a growth arising from right lateral wall of carina occluding 50% of the lumen and detailed histopathological examination revealed it to be a MEC of the trachea. Patient underwent local excision of the tumor with primary anastomosis. In view of positive margins adjuvant radiotherapy of 60 Gy in 30 fractions were given to the tumor bed. Patient tolerated the treatment well and is disease free at 6 months follow-up. Experience with MEC of the trachea in children is limited and optimal treatment protocols have not been defined, with current treatment mainly extrapolated from MEC of the salivary glands.

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“…Endoscopic laser-assisted procedures may even assist in performing symptomatic debulking of tracheal masses in case of unresectable lesions, but have also been employed for temporary management of benign or low-grade tumors in order to delay definitive open surgery, allowing children to grow and therefore possibly reducing intra-and postoperative complication rates (8,13).…”

Section: Endoscopic Treatmentmentioning

confidence: 99%

“…Wheezing and stridor constitute the most common presentation in PTTs, followed by cough and pneumonia (4,7,8). For this reason, the most frequent misdiagnosis of PTTs in this age cohort is asthma: the ensuing inappropriate use of bronchodilators may partially mask, at least at beginning, a diagnosis of tumor and delay its correct surgical treatment in a significant percentage of cases (1).…”

Section: Introductionmentioning

confidence: 99%

“…By contrast, dyspnea as an initial symptom is rather uncommon, since it develops only when the tumor significantly reduces tracheal lumen patency to less than 50% (1). On the other hand, hemoptysis appears when the overlying mucosa becomes ulcerated and is rare in benign tumors, being mainly described in MEC (6,8). In case of carcinoid tumors, carcinoid syndrome with hypotension, diarrhea, and flushing has been described in 30% of cases, in various association with non-specific endoluminal massrelated signs and symptoms (6).…”

Section: Introductionmentioning

confidence: 99%

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Surgical treatment of primary tracheal tumors in children and adolescents

Giannini¹,

Incandela²,

Bresciani³

et al. 2019

Pediatr Med

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Pediatric primary tracheal tumors (PTTs) are rare entities, with an estimated incidence of 0.2% among all neoplasms in children and adolescents. Benign lesions and malignancies are rather equally represented, with subglottic hemangioma, granular cell tumor, carcinoid tumor, and low-grade mucoepidermoid carcinoma being the most common histotypes. Guidelines on management and treatment of pediatric PTTs are not available, and only a few reviews, case reports, and single surgeon/institute experiences have been published. A literature search was carried out focusing on the surgical approaches utilized in the most recent publications to manage pediatric PTTs, thus including case reports, single institute experiences, and reviews on surgical techniques. Moreover, we divided the available intervention modalities based on an anatomical classification, distinguishing between laryngotracheal, cervical tracheal, lower tracheal, and carinal scenarios. Endoscopic treatment is still underused, even for benign lesions: this is mainly due to the difficulties that surgeons may experience during airway management, appropriate tumor visualization, and its safe removal with adequate prevention/management of intraoperative complications.Considering open surgery, simple tumorectomy via median thyrotomy is the treatment of choice whenever possible (mainly for benign tumors), whereas in case of wider excisions, laryngotracheal resection and reconstruction with cartilage graft, end-to-end anastomosis, or neo-carinal reconstruction represent the most widely used procedures. All these techniques are similar to what described in adults. Strict cooperation with an experienced team of pediatric anesthesiologists and intensivists is of paramount importance for the adequate management of PTTs in young children. We are far from establishing a common guideline for treatment of PTTs. Mini-invasive procedures should be encouraged and developed since the majority of pediatric histotypes are benign or low-grade cancers. Moreover, patients should be addressed to specialized pediatric centers in order to improve and refine the existing techniques, laying the groundwork for the proposal of new procedures.

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Primary mucoepidermoid carcinoma at the carina of trachea presenting with wheezing in an asthmatic child mimicking an attack of asthma

Cited by 6 publications

References 17 publications

Resolution of asthmatic symptoms following successful endoscopic resection of tracheal mucoepidermoid carcinoma

Resolution of asthmatic symptoms following successful endoscopic resection of tracheal mucoepidermoid carcinoma

Mucoepidermoid carcinoma of the trachea in a 9-year-old male child: case report and review of literature

Surgical treatment of primary tracheal tumors in children and adolescents

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