Pediatric pulmonary mucoepidermoid carcinoma in a 5-year-old patient

A 5-year-old male presented to our respiratory department with a 1-year history of recurrent cough, expectoration, and intermittent fever. Physical examination revealed diminished breath sounds over the left lower lung field. Contrast-enhanced chest computed tomography demonstrated a 3 cm heterogeneously enhancing mass at the left pulmonary hilum (Figure 1A, white arrow), causing complete occlusion of the left lower lobe bronchus with associated atelectasis (Figure 1B, black arrows). Notably, mediastinal and hilar lymphadenopathy were absent, and no osseous abnormalities were observed. Retrospective analysis of a chest radiograph obtained 1 year prior revealed nonspecific patchy opacities in the left lower lung field (Figure 2A, black arrow), suggesting possible disease progression. Bronchoscopy revealed tumor tissue at the opening of the lower left lobe and the biopsy results confirmed the diagnosis of a mucoepidermoid carcinoma. The patient underwent complete thoracoscopic left lower lobar sleeve resection with en bloc hilar-mediastinal lymph node dissection. Final pathology confirmed a low-grade mucoepidermoid carcinoma (Figure 2B) with negative nodal involvement. Given the favorable histology and complete resection, adjuvant therapy was not administered. The patient remains disease-free at 6-year postoperative follow-up, demonstrating preserved pulmonary function and normal growth parameters.

Figure 1 Chest computed tomography. (A) Chest computed tomography showed a mass with a maximum diameter of 3 cm in the lower left lung hilum with significant enhancement (white arrow). (B) The left lower lobe bronchus is occluded, accompanied by atelectasis (black arrows).

Figure 2 Chest radiograph (1 year prior) and pathology. (A) A chest radiograph obtained 1 year prior revealed nonspecific patchy opacities in the left lower lung field (black arrow). (B) Pathology, with hematoxylin and eosin (H&E) staining, confirmed the diagnosis of a mucoepidermoid carcinoma. R, right.

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Provenance and Peer Review: This article was a standard submission to the journal. The article has undergone external peer review.

Peer Review File: Available at https://tp.amegroups.com/article/view/10.21037/tp-2024-490/prf

Funding: This study was supported by Guangdong Provincial Basic and Applied Basic Research Fund of China (No. 2020A1515110445); 2024–2026 Guangzhou High Level Clinical Key Specialty Construction—Lung Transplantation; Major Project of Guangzhou National Laboratory (No. GZNL2023A01003).

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tp.amegroups.com/article/view/10.21037/tp-2024-490/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The Ethics Committee of the First Affiliated Hospital of Guangzhou Medical University approved this study (No. ES-2024-K100-01). Written informed consent was obtained from the patient’s father. The study conformed to the provisions of the Declaration of Helsinki and its subsequent amendments.

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