Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2024; 12(8): 1422-1429
Published online Mar 16, 2024. doi: 10.12998/wjcc.v12.i8.1422
Left lower lobe sleeve resection for the clear cell variant of pulmonary mucoepidermoid carcinoma: A case report
Xiao-Hui Yu, Wen-Xiang Wang, De-Song Yang, Liang-Hui Gong
Xiao-Hui Yu, Department of Pathology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
Wen-Xiang Wang, De-Song Yang, Liang-Hui Gong, The Second Department of Thoracic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
Author contributions: Yu XH, Wang WX, and Yang DS contributed to manuscript writing and editing; Gong LH contributed to conceptualization and supervision; All authors have read and approved the final manuscript.
Supported by Hunan Provincial Natural Science Foundation of China, No. 2022JJ40246; and The Hunan Cancer Hospital Climb Plan, No. 2021NSFC-B005.
Informed consent statement: We obtained informed written consent from the patient to publish this case report and any accompanying images.
Conflict-of-interest statement: The authors declare having no relevant conflicts of interest related to this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Liang-Hui Gong, MD, PhD, Surgeon, The Second Department of Thoracic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, No. 283 Tongzipo Road, Yuelu District, Changsha 410031, Hunan Province, China. gonglianghui@hnca.org.cn
Received: November 22, 2023
Peer-review started: November 22, 2023
First decision: December 27, 2023
Revised: January 8, 2024
Accepted: February 8, 2024
Article in press: February 8, 2024
Published online: March 16, 2024
Processing time: 110 Days and 14.5 Hours
Abstract
BACKGROUND

Pulmonary mucoepidermoid carcinoma (PMEC) is a rare malignancy that arises from minor salivary glands within the tracheobronchial tree. The clear cell variant of PMEC is exceptionally uncommon and presents notable diagnostic challenges, primarily attributable to its morphological similarity to other tumors containing clear cells.

CASE SUMMARY

A 22-year-old male, formerly in good health, came in with a two-month duration of persistent cough and production of sputum. Subsequent imaging and bronchoscopy examinations revealed a 2 cm tumor in the distal left main bronchus, which resulted in complete atelectasis of the left lung. Further assessment via positron emission tomography/computed tomography scans and endoscopic biopsy confirmed the primary malignant nature of the tumor, characterized by clear cell morphology in most of the tumor cells. The patient underwent a left lower lobe sleeve resection accompanied by systematic mediastinal lymph node dissection. Molecular pathology analysis subsequently revealed a CRTC3-MAML2 gene fusion, leading to a definitive pathological diagnosis of the clear cell variant of PMEC, staged as T2N0M0. After surgery, the patient experienced a smooth recovery and exhibited no signs of recurrence during the one-and-a-half-year follow-up period.

CONCLUSION

This article describes an unusual case of a clear cell variant of PMEC characterized by the presence of a CRTC3-MAML2 gene fusion in a 22-year-old male. The patient underwent successful left lower lobe sleeve resection. This case underscores the distinctive challenges associated with diagnosing and treating this uncommon malignancy, underscoring the importance of precise diagnosis and personalized treatment strategies.

Keywords: Pulmonary mucoepidermoid carcinoma; Clear cell variant; CRTC3-MAML2 gene fusion; Sleeve lobectomy; Case report

Core Tip: Pulmonary mucoepidermoid carcinoma (PMEC) is an uncommon malignancy originating from the minor salivary glands of the tracheobronchial tree. Its clear cell variant, even rarer, presents distinctive diagnostic challenges due to its morphological similarity to other clear cell tumors. This report describes the case of a 22-year-old male diagnosed with the clear cell variant of PMEC characterized by the CRTC3-MAML2 gene fusion. The patient successfully underwent a left lower lobe sleeve resection without the need for adjuvant therapy. At the one-and-a-half-year postoperative follow-up assessment, he exhibited no signs of recurrence.