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Chen Q, Cheng J, Wang L, Lv X, Hu J. Primary lung cancer in children and adolescents. J Cancer Res Clin Oncol 2024; 150:225. [PMID: 38695944 PMCID: PMC11065912 DOI: 10.1007/s00432-024-05750-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/11/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE Primary lung cancer is extremely rare in children and adolescents. The aim of this study is to clarify clinical features and outcomes of primary lung cancer in children and adolescents. METHODS Young patients (aged ≤ 20 years) diagnosed as primary lung cancer between 2012 and 2023 were retrospective reviewed. According to radiological appearance of the nodules, they were divided into solid nodule (SN) group and ground glass opacity (GGO) group. RESULTS A total of 74 patients were identified, with a median age at diagnosis of 18 years old (range: 11-20), including 7 patients in SN group and 67 patients in GGO group. In the GGO group, none of the nodules enlarged or changed during an average surveillance period of 10.8 months before surgery, except one. Wedge resection was the most common procedure (82.1%), followed by segmentectomy (16.4%) and lobectomy (1.5%). Histopathological analysis revealed that 64.2% of GGO nodules were adenocarcinoma in situ and minimally invasive adenocarcinomas, while the remaining 35.8% were invasive adenocarcinomas. Mutational analysis was performed in nine patients, with mutations identified in all cases. After a mean follow-up period of 1.73 ± 1.62 years, two patients in the SN group died due to multiple distant metastases, while all patients in the GGO group survived without recurrence. The overall survival (100%) of the GGO group was significantly higher than SN group (66.7%). CONCLUSIONS Primary lung cancer in children and adolescents are rare and histopathological heterogeneous. Persistent GGO nodules may indicate early-stage lung adenocarcinoma in children and adolescents.
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Affiliation(s)
- Qiuming Chen
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Jun Cheng
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Luming Wang
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiayi Lv
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jian Hu
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Nishida N, Onishi S, Murakami M, Kawano T, Muto M, Ieiri S. Successful complete tumor resection for pulmonary mucoepidermoid carcinoma by thoracoscopic right upper lobectomy with intraoperative bronchoscopy: A pediatric case report. Int J Surg Case Rep 2023; 105:108119. [PMID: 37028186 PMCID: PMC10112141 DOI: 10.1016/j.ijscr.2023.108119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 04/08/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Mucoepidermoid carcinoma presents as an exophytic endobronchial mass that induces obstructive symptoms often followed by distal collapse atelectasis of the lung parenchyma. CASE PRESENTATION A six-year-old girl had recurrent bacterial pneumonia and atelectasis of the right upper lobe. Computed tomography revealed a 30-mm mass in the anterior segment of the right upper lobe with an obstructed trachea and peripheral atelectasis. A minor salivary gland tumor was suspected, so thoracoscopic right upper lobectomy (RUL) was performed. Intraoperative bronchoscopy showed no protrusion of the tumor into the tracheal lumen. We confirmed that there was no injury to the middle lobe branch and no residual tumor via bronchoscopy before transection of the trachel bronchus of the right upper lobe. The histological type was low-grade mucoepidermoid carcinoma. The postoperative course was uneventful, and no recurrence was evident after one year. CLINICAL DISCUSSION Primary pulmonary cancers in children are extremely rare. Mucoepidermoid carcinoma is the most common disease in pediatric primary lung tumors but remains relatively rare. Mucoepidermoid carcinoma of the tracheobronchial tree sometimes requires sleeve resection. Intraoperative bronchoscopy helped determine the exact position of the tumor. The value of intraoperative bronchoscopy for sparing the lung parenchyma and preserving as much of the respiratory function as possible. Intraoperative bronchoscopy should be actively performed in cases of pediatric lobectomy, especially those involving tracheobronchial tumors. CONCLUSION Intraoperative bronchoscopy allowed for complete RUL without residual tumor or injury of the middle lobe bronchus.
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Wordui SM, Lakhan A, Eze J, Nowalaza Z, Makate S, Brooks A, De Decker R, Banderker E, Pillay K, Singh S, Hendricks M, Gray D, Zampoli M, Vanker A. Mucoepidermoid carcinoma of the bronchus in two children: Case reports. Respir Med Case Rep 2023; 43:101858. [PMID: 37168990 PMCID: PMC10165254 DOI: 10.1016/j.rmcr.2023.101858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 04/23/2023] [Indexed: 05/13/2023] Open
Abstract
Childhood mucoepidermoid carcinomas (MEC) of the bronchus are rare. They present with non-specific symptoms and signs making diagnosis delayed. We present two children with bronchial MEC managed in a tertiary children's hospital in Cape Town, South Africa. The first was a 11-year male with recurrent haemoptysis and the second child was a 6-year female with recurrent unifocal pneumonia. Chest CT scan and bronchoscopy with biopsy confirmed the diagnosis. Both patients underwent treatment, including surgery and are doing well. It is important to exclude endobronchial lesions when children present with recurrent respiratory symptoms, since early diagnosis will enable lung-sparing treatment.
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Affiliation(s)
- Seyram M. Wordui
- Division of Pulmonology, Red Cross War Memorial Children's Hospital: University of Cape Town, South Africa
- Corresponding author. C/o African Paediatric Fellowship Programme, ICH Building, Room 2.19, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
| | - Aruna Lakhan
- Division of Pulmonology, Red Cross War Memorial Children's Hospital: University of Cape Town, South Africa
| | - Joy Eze
- Division of Pulmonology, Red Cross War Memorial Children's Hospital: University of Cape Town, South Africa
| | - Zandiswa Nowalaza
- Division of Pulmonology, Red Cross War Memorial Children's Hospital: University of Cape Town, South Africa
| | - Sindiswa Makate
- Division of Pulmonology, Red Cross War Memorial Children's Hospital: University of Cape Town, South Africa
| | - Andre Brooks
- Chris Barnard Division of Paediatric Cardiothoracic Surgery, Red Cross War Memorial Children's Hospital: University of Cape Town, South Africa
| | - Rik De Decker
- Division of Paediatric Cardiology, Red Cross War Memorial Children's Hospital: University of Cape Town, South Africa
| | - Ebrahim Banderker
- Division of Diagnostic Radiology, Red Cross War Memorial Children's Hospital: University of Cape Town, South Africa
| | - Komala Pillay
- Division of Anatomical Pathology, Red Cross War Memorial Children's Hospital: University of Cape Town and National Health Laboratory Services, South Africa
| | - Shivani Singh
- Division of Anatomical Pathology, Red Cross War Memorial Children's Hospital: University of Cape Town and National Health Laboratory Services, South Africa
| | - Marc Hendricks
- Division of Paediatric Oncology, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital: University of Cape Town, South Africa
| | - Diane Gray
- Division of Pulmonology, Red Cross War Memorial Children's Hospital: University of Cape Town, South Africa
| | - Marco Zampoli
- Division of Pulmonology, Red Cross War Memorial Children's Hospital: University of Cape Town, South Africa
| | - Aneesa Vanker
- Division of Pulmonology, Red Cross War Memorial Children's Hospital: University of Cape Town, South Africa
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Abele M, Bajčiová V, Wright F, Behjati S, Voggel S, Schneider DT, Mallebranche C, Česen Mazič M, Guillén G, Krawczyk M, Bień E, Roganovic J, Bisogno G, Chiaravalli S, Ferrari A, Brecht IB, Orbach D, Reguerre Y, Virgone C. Primary lung carcinoma in children and adolescents: An analysis of the European Cooperative Study Group on Paediatric Rare Tumours (EXPeRT). Eur J Cancer 2022; 175:19-30. [PMID: 36087394 DOI: 10.1016/j.ejca.2022.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/26/2022] [Accepted: 08/05/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Primary lung carcinoma is an exceptionally rare childhood tumour, as per definition of the European Cooperative Study Group on Paediatric Rare Tumours (EXPeRT), with an incidence of 0.1-0.2/1,000,000 per year. Little is known about the clinical characteristics of children with primary lung carcinoma, a gap which this joint analysis of the EXPeRT group aimed to fill. PATIENTS AND METHODS We performed a retrospective case series of children (aged 0-18 years) with primary lung carcinoma, as collected through the EXPeRT databases between 2000 and 2021. We recorded relevant clinical characteristics including treatment and outcome. RESULTS Thirty-eight patients were identified with a median age of 12.8 years at diagnosis (range: 0-17). Mucoepidermoid carcinoma (MEC) was the most frequent entity (n = 20), followed by adenocarcinoma (n = 12), squamous cell carcinoma (n = 4), adenosquamous carcinoma (n = 1) and small-cell lung cancer (n = 1). Patients with MEC presented rarely with lymph node metastases (2/20 cases). Overall, 19/20 patients achieved long-lasting remission by surgical resection only. Patients with other histologies often presented in advanced stages (14/18 TNM stage IV). With multimodal treatment, 3-year overall survival was 52% ± 13%. While all patients with squamous cell carcinoma died, the 12 patients with adenocarcinoma had a 3-year overall survival of 64% ± 15%. CONCLUSIONS Primary lung carcinomas rarely occur in children. While the outcome of children with MEC is favourable with surgery alone, patients with other histotypes have a poor prognosis, despite aggressive treatment, highlighting the need to develop new strategies for these children, such as mutation-guided treatment.
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Affiliation(s)
- Michael Abele
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany.
| | - Viera Bajčiová
- Department of Pediatric Oncology, Childrens University Hospital, Brno, Czech Republic
| | - Fiona Wright
- Department of Pediatric Hematology and Oncology, Cambridge Univeristy Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - Sam Behjati
- Department of Pediatric Hematology and Oncology, Cambridge Univeristy Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - Sarah Voggel
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
| | - Dominik T Schneider
- Clinic of Pediatrics, Klinikum Dortmund, University Witten/Herdecke, Dortmund, Germany
| | | | | | - Gabriela Guillén
- Surgical Oncology and Neonatal Surgery, Pediatric Surgery Department, Hospital Infantil Universitari Vall d'Hebron, Barcelona, Spain
| | - Malgorzata Krawczyk
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Ewa Bień
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Jelena Roganovic
- Hematology-Oncology Division, Department of Pediatrics, Clinical Hospital Center Rijeka, University of Rijeka, Rijeka, Croatia
| | - Gianni Bisogno
- Hematology-Oncology Division, Department of Pediatrics, Padova University Hospital, Padua, Italy
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Ines B Brecht
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Yves Reguerre
- Department of Pediatric Hematology and Oncology, Félix Guyon University Hospital, St Denis, Réunion Island, France
| | - Calogero Virgone
- Pediatric Surgery, Department of Women's and Children's Health, University of Padua, Padua, Italy
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