Prognosis of mucoepidermoid carcinoma of the bronchi

BACKGROUND: Mucoepidermoid cancer is exceptional in the respiratory tract, accounting for only 0.2% of primary lung cancers.CASE REPORTS: We report three cases of mucoepidermoid carcinoma. The inaugural signs were hemoptysia in a 10-year-old child, recurrent lower respiratory tract infections in a 13-year-old child, and dyspnea with chest pain in a 32-year-old adult. Bronchial fibroscopy disclosed a proximal endobronchial tumor in all three patients. Pathology study of the operative specimen identified low-grade malignant mucoepidermoid carcinoma in the two children and high-grade malignant mucoepidermoid carcinoma in the adult. Surgical resection was performed for the pediatric cases. Outcome was favorable with recurrence-free survival at eight years in the first child. The surgical resection was less radical in the second child due to locoregional extension. This child was lost to follow-up. The clinical course was rapidly fatal in the third patient who presented metastatic spread at diagnosis and died one month later.DISCUSSION: The prognosis of mucoepidermoid tumors of the bronchi is closely related to tumor grade and extension at diagnosis. Unlike high-grade mucoepidermoid carcinoma, the progression of low-grade tumors, which predominate in children, is generally slow, enabling good prognosis if diagnosis is established early. Early search for these tumors in patients presenting chronic or recurrent respiratory manifestations would avoid late diagnosis and improve prognosis.