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Cho HJ, Yoon J, Lee E, Lee YS, Kim SY, Roh JL, Kim DK, Choi SH, Park SI, Kim YH, Koh KN, Im HJ, Seo JJ, Hong SJ, Yu J. The Different Clinical Aspects of Pediatric Primary Airway Tumors in the Larynx, Trachea, and Bronchi. J Korean Med Sci 2017; 32:1304-1311. [PMID: 28665067 PMCID: PMC5494330 DOI: 10.3346/jkms.2017.32.8.1304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/18/2017] [Indexed: 01/31/2023] Open
Abstract
Primary airway tumors are rare in children and no literature reviewed their characteristics each location. We evaluate the clinical characteristics and outcomes of Korean children with primary airway tumors, from the larynx to bronchi. A retrospective chart review of children with primary tumors of the larynx, trachea, and bronchi at Asan Medical Center from January 2000 to July 2016 was conducted. Nineteen children were diagnosed with primary airway tumors of the larynx (47.4%), trachea (10.5%), and bronchi (42.1%). Median follow-up duration was 2.8 years and there were recurrences in 21.1%. Laryngeal tumors were associated with a younger median age at onset (2 months) and diagnosis (4 months), and most were relatively small (median size = 5.3 mm) and symptomatic. Tracheal and bronchial tumors were found in older children (age at onset and diagnosis > 11 years) and large (> 15.0 mm). Most (75%) patients with bronchial tumors were asymptomatic and all the patients with tracheal tumors were symptomatic. This study suggests that we should consider different the locations in primary airway tumor based on the age at onset and diagnosis, initial symptoms or signs, and size of tumor.
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Affiliation(s)
- Hyun Ju Cho
- Division of Pediatric Allergy and Respiratory, Department of Pediatrics, Childhood Asthma Atopy Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jisun Yoon
- Division of Pediatric Allergy and Respiratory, Department of Pediatrics, Childhood Asthma Atopy Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea
| | - Yoon Se Lee
- Department of Otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sang Yoon Kim
- Department of Otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jong Lyel Roh
- Department of Otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Dong Kwan Kim
- Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Se Hoon Choi
- Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung Il Park
- Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Yong Hee Kim
- Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyung Nam Koh
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Korea
| | - Ho Joon Im
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Korea
| | - Jong Jin Seo
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Korea
| | - Soo Jong Hong
- Division of Pediatric Allergy and Respiratory, Department of Pediatrics, Childhood Asthma Atopy Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jinho Yu
- Division of Pediatric Allergy and Respiratory, Department of Pediatrics, Childhood Asthma Atopy Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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Cheng DL, Hu YX, Hu PQ, Wen G, Liu K. Clinicopathological and multisection CT features of primary pulmonary mucoepidermoid carcinoma. Clin Radiol 2017; 72:610.e1-610.e7. [PMID: 28292512 DOI: 10.1016/j.crad.2017.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 01/22/2017] [Accepted: 02/07/2017] [Indexed: 12/26/2022]
Abstract
AIM To delineate the multisection computed tomography (MSCT) features and the clinical characteristics of primary pulmonary mucoepidermoid carcinoma (PMEC). Prognostic factors were also analysed. MATERIALS AND METHODS A retrospective study was undertaken to investigate the medical records and MSCT performance of histopathologically confirmed PMECs from 2007 to 2015. RESULTS A total of 83.3% of patients with high-grade PMECs were aged >40 years, whereas there were 1.5-times more women than men with low-grade PMECs. Cough (n=29) and haemoptysis (n=12) were the most common symptoms. Upon MSCT, 30 cases showed a round or lobulate mass, and few demonstrated bronchial-wall thickening or cavities. Distal obstruction (n=14) and "air crescent sign" (n=5) could be detected. Tumours showed mild (n=19), moderate (n=5), and marked enhancement (n=5). Moreover, 18 cases showed foci of low density in lesions. Mean survival for patients with low-grade PMECs was 59.2 months, whereas that for high-grade PMECs was 20.4 months; 3-year survival rates were 55% and 14%, respectively. Tumour staging was a significant independent predictor of survival according to the Cox proportional hazards model. CONCLUSION High-grade PMECs occurred more frequently in patients aged >40 years and were more predominant in men. Young females were predisposed to having low-grade PMECs. MSCT revealed an oval or lobulate mass with mild enhancement, as manifested by calcification and visible mucus lakes, which may be suggestive of PMECs. Furthermore, a central nodule or mass may suggest low-grade PMECs; high-grade PMECs tend to be peripheral and associated with lymph-node metastasis. Pathological grade, lymph node metastasis, and TNM stage correlate with the survival of patients with PMEC.
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Affiliation(s)
- D-L Cheng
- Medical Imaging Center, Nanfang Hospital, Southern Medial University, Guangzhou, People's Republic of China
| | - Y-X Hu
- Medical Imaging Center, Nanfang Hospital, Southern Medial University, Guangzhou, People's Republic of China
| | - P-Q Hu
- Medical Imaging Center, Nanfang Hospital, Southern Medial University, Guangzhou, People's Republic of China
| | - G Wen
- Medical Imaging Center, Nanfang Hospital, Southern Medial University, Guangzhou, People's Republic of China.
| | - K Liu
- Medical Imaging Center, Nanfang Hospital, Southern Medial University, Guangzhou, People's Republic of China
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Vageriya NL, Shah RS, Prabhu S, Naphade D, Athawale HR. Intra bronchial mucoepidermoid carcinoma in an 8 year old girl: A case report of rare tumor with review of literature. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2016.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Jaramillo S, Rojas Y, Slater BJ, Baker ML, Hicks MJ, Muscal JA, Vece TJ, Wesson DE, Nuchtern JG. Childhood and adolescent tracheobronchial mucoepidermoid carcinoma (MEC): a case-series and review of the literature. Pediatr Surg Int 2016; 32:417-24. [PMID: 26790674 DOI: 10.1007/s00383-015-3849-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/20/2014] [Indexed: 01/30/2023]
Abstract
Tracheobronchial mucoepidermoid carcinomas (MEC) are rare in the pediatric population with literature limited primarily to case reports. Here we present our institutional experience treating MEC in three patients and review the literature of 142 pediatric cases previously published from 1968 to 2013. Although rare, tracheobronchial MEC should be included in the differential diagnosis in a child with recurrent respiratory symptoms. Conservative surgical management is often sufficient to achieve complete resection and good outcomes.
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Affiliation(s)
- Sergio Jaramillo
- Department of Radiation Oncology, Baylor College of Medicine, Houston, TX, USA
| | - Yesenia Rojas
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, 6701 Fannin, Suite 1210, Houston, 77030, TX, USA
| | - Bethany J Slater
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, 6701 Fannin, Suite 1210, Houston, 77030, TX, USA
| | - Michael L Baker
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA
| | - M John Hicks
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA
| | - Jodi A Muscal
- Division of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Timothy J Vece
- Division of Pulmonary Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - David E Wesson
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, 6701 Fannin, Suite 1210, Houston, 77030, TX, USA
| | - Jed G Nuchtern
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, 6701 Fannin, Suite 1210, Houston, 77030, TX, USA.
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Madafferi S, Catania VD, Accinni A, Boldrini R, Inserra A. Endobronchial tumor in children: Unusual finding in recurrent pneumonia, report of three cases. World J Clin Pediatr 2015; 4:30-34. [PMID: 26015878 PMCID: PMC4438439 DOI: 10.5409/wjcp.v4.i2.30] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 01/27/2015] [Accepted: 04/02/2015] [Indexed: 02/05/2023] Open
Abstract
We are reporting 3 cases of pediatric endobronchial tumors presented with recurrent pneumonia. The median age of patients, at time of presentation, was 10.6 years. All patients presented with recurrent pneumonia with a mean time to occurrence, after onset of symptoms, of 14 mo. Bronchoscopy was early performed as part of diagnostic work-up and it revealed an endobronchial mass in every case. Complete surgical resection was performed in all cases, with lung preservation in two of them. Neither post-operative chemotherapy nor radiotherapy was required. The mean duration of follow-up was 7 years and all patients are still alive and disease-free. Recurrent pneumonia, in pediatrics, should raise the suspicion of an obstructing lesion, congenital malformation or systemic disease. A systematic approach is useful for organize the clinicians initial workup. Prompt diagnosis allows parenchymal-sparing surgery, which offers the best chance of cure and reduces clinical and functional complications in these patients.
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Qian X, Sun Z, Pan W, Ye Q, Tang J, Cao Z. Childhood bronchial mucoepidermoid tumors: A case report and literature review. Oncol Lett 2013; 6:1409-1412. [PMID: 24179533 PMCID: PMC3813739 DOI: 10.3892/ol.2013.1529] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 08/02/2013] [Indexed: 01/12/2023] Open
Abstract
Primary pulmonary neoplasms rarely occur in children, but the majority of those that do are malignant. Mucoepidermoid carcinoma (MEC) represents ~10% of all primary pulmonary malignant tumors. However, MEC is not usually considered in the clinical differential diagnosis in pediatric practice. The present study presents the case of a seven-year-old female with a one-year history of recurrent hemoptysis. Computerized tomography (CT) scans revealed a tumor originating in the right lower lobe bronchus. The patient did not receive any radiation and chemotherapy following a lobectomy on the right lower lung. The tumor was histopathologically determined to be an MEC of the tracheobronchial tree. Subsequent to a six-year follow-up, the MEC was undetectable in this patient, according to the clinical and radiological evidence. The literature with regard to pediatric MEC is also reviewed in this study.
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Affiliation(s)
- Xiaozhe Qian
- Department of General Thoracic Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P.R. China
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Dyhdalo KS, Chen L. Endobronchial ultrasound-guided fine-needle aspiration cytology of bronchial low-grade mucoepidermoid carcinoma: Rapid on-site evaluation of cytopathologic findings. Diagn Cytopathol 2012; 41:1096-9. [DOI: 10.1002/dc.22928] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 08/10/2012] [Indexed: 12/19/2022]
Affiliation(s)
| | - Longwen Chen
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Scottsdale Arizona
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Kanemoto A, Oshiro Y, Sugahara S, Kamagata S, Hirobe S, Toma M, Okumura T, Sakurai H. Proton Beam Therapy for Inoperable Recurrence of Bronchial High-grade Mucoepidermoid Carcinoma. Jpn J Clin Oncol 2012; 42:552-5. [DOI: 10.1093/jjco/hys047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Li X, Zhang W, Wu X, Sun C, Chen M, Zeng Q. Mucoepidermoid carcinoma of the lung: common findings and unusual appearances on CT. Clin Imaging 2012; 36:8-13. [DOI: 10.1016/j.clinimag.2011.03.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Accepted: 11/01/2010] [Indexed: 10/14/2022]
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Lee EY, Vargas SO, Sawicki GS, Boyer D, Grant FD, Voss SD. Mucoepidermoid carcinoma of bronchus in a pediatric patient: (18)F-FDG PET findings. Pediatr Radiol 2007; 37:1278-82. [PMID: 17922270 DOI: 10.1007/s00247-007-0607-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2007] [Revised: 07/12/2007] [Accepted: 07/20/2007] [Indexed: 11/29/2022]
Abstract
In children, primary neoplasms of the tracheobronchial tree and lungs are rare; most are malignant. Of the primary malignant pulmonary neoplasms arising in childhood, mucoepidermoid carcinoma accounts for approximately 10%. Due to its well-confined local growth within the airway, mucoepidermoid carcinoma commonly produces respiratory symptoms from progressive tracheal or bronchial obstruction. Mucoepidermoid tumor has minimal metastatic potential in children, and local resection alone is the current treatment of choice. Early detection, diagnosis, and surgical resection of mucoepidermoid tumor are especially important in pediatric patients since the bulk of the remaining pulmonary parenchyma can be preserved, thereby decreasing the thoracic deformity and pulmonary functional morbidity. Radiographic and CT imaging findings of bronchial mucoepidermoid carcinoma in children have been described in several case reports. However, to the best of our knowledge, imaging findings of 2-((18)F)-fluoro-2-deoxy-D: -glucose positron emission tomography ((18)F-FDG PET) of mucoepidermoid carcinoma of the bronchus in pediatric patients have not been well established. We report a mucoepidermoid carcinoma arising from the right upper lobe bronchus in a 15-year-old girl with an emphasis on the (18)F-FDG PET findings.
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Affiliation(s)
- Edward Y Lee
- Department of Radiology and Medicine, Pulmonary Division, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
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Abstract
The authors describe a rare case of mucoepidermal carcinoma of the lung incidentally identified in preoperative assessments for inguinal hernia repair in a 5-year-old girl. This patient was referred for right external inguinal hernia, and a 3.0-cm round-shaped lesion was found in the right lower lung field of a chest x-ray film. She had no respiratory tract complaints, but her serum carcinoembryonic antigen concentration was markedly elevated (21.2 ng/mL). Chest and abdominal computed tomography/magnetic resonance images could not determine the nature of the lesion, but 2-[18 F]fluoro-2-deoxy- d -glucose positron emission tomography (FDG-PET) indicated a malignant tumor pattern. The patient underwent a computed tomography-guided needle biopsy of the lesion (S8), which was soon followed by a right lower pulmonary lobectomy. Histopathology of the resected specimen showed mucoepidermal carcinoma with no regional lymph node metastasis. In childhood asymptomatic pulmonary lesions, it is often difficult to rule out the possibility of malignancy. In the present case, FDG-PET scanning appropriately indicated the therapeutic priority of pediatric thoracic surgery.
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Vogelberg C, Mohr B, Fitze G, Friedrich K, Hahn G, Roesner D, Leupold W, Suttorp M. Mucoepidermoid carcinoma as an unusual cause for recurrent respiratory infections in a child. J Pediatr Hematol Oncol 2005; 27:162-5. [PMID: 15750450 DOI: 10.1097/01.mph.0000155120.50936.73] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Recurrent respiratory infections in a 9-year-old girl prompted a chest radiograph and a CT scan, which showed a right middle lobe consolidation. Bronchoscopy revealed a tumor that totally obstructed the middle lobe. Open lung biopsy revealed a low-grade mucoepidermoid carcinoma. Middle and lower right lung lobectomy was performed, followed by an uneventful recovery. Cytogenetic investigation of tumor cells exhibited the translocation t(11;19). This case shows that further diagnostic modalities such as CT scanning should be performed early in children with recurrent lower respiratory tract infections who have suspicious radiographic findings such as persistent atelectasis or recurrent unifocal infiltration. Bronchial mucoepidermoid carcinoma is infrequent, and molecular investigations might shed additional light on the prognosis.
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Affiliation(s)
- Christian Vogelberg
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany.
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Vogelberg C, Suttorp M. To the editor: Re: "Mucoepidermoid carcinoma of the bronchus presenting with a negative chest X-ray and normal pulmonary function in two teenagers: two case reports and review of the literature" by Robert J. Giusti and Raja M. Flores (Pediatric Pulmonology 2004;37:81-84). Pediatr Pulmonol 2004; 38:359-60; author reply 361-2. [PMID: 15334519 DOI: 10.1002/ppul.20106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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