Bone marrow metastasis in primary bronchial mucoepidermoid carcinoma: a case report
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Bone marrow metastasis in primary bronchial mucoepidermoid carcinoma: a case report Zhenyu Pan1†, Guozi Yang1†, Limei Qu2, Tingting Yuan3, Zhonghua Du4 and Lihua Dong1*
Abstract Primary bronchial mucoepidermoid carcinoma in the lung is relatively rare. It rarely presents with the highly malignant biological characteristic of bone marrow metastasis. We describe a case of this disease with bone marrow metastasis. A 56-year-old man with the primary manifestation of bone pain and bloodstained sputum had two abnormal shadows on the left inferior lobar bronchus and peripheral tissue of the lower lobe of the left lung, respectively. Computed tomography-guided percutaneous puncture biopsy and bone imaging confirmed the diagnosis of high-grade bronchial mucoepidermoid carcinoma with bone metastasis. However, the patient soon presented with progressive hemoglobin and platelet decline and severe multi-organ hemorrhage. Subsequently, we performed bone marrow aspiration and biopsy, which revealed malignant cells and necrosis. The patient deteriorated rapidly from the disease, and died on the 16th day of admission. We hope that this case report will increase awareness of the possibility of primary high-grade bronchial mucoepidermoid carcinoma metastasizing to the bone marrow, which might be a poor prognostic factor. Keywords: Mucoepidermoid carcinoma, Lung, Bone marrow metastasis
Background Primary bronchial mucoepidermoid carcinoma, a lowmalignant potential tumor of bronchial gland origin, is relatively rare and comprises approximately 0.1% of all malignant lung tumors [1]. Compared with most other lung cancers, it occurs in relatively young people [2-4]. Although mucoepidermoid carcinomas are malignant tumors, they are usually indolent, with chronic progression. Surgical treatment yields a favorable prognosis; the 5-year survival rate is 95% and adjuvant treatment is considered unnecessary. Mucoepidermoid carcinomas rarely present highly malignant biological characteristics, especially bone marrow metastasis. We report a case of unusually aggressive bronchial mucoepidermoid carcinoma with bone marrow metastasis with the aim of raising awareness of the malignant biological behavior of this tumor.
* Correspondence: [email protected] † Equal contributors 1 Department of Radiotherapy, Norman Bethune First Hospital, Jilin University, 71 Xinmin Street, Changchun 130021, China Full list of author information is available at the end of the article
Case presentation A 56-year-old man presented to our hospital complaining of osphyalgia, dorsalgia, and melosalgia for 2 months, and bloodstained sputum for 2 weeks. He had been a drinker and smoker for more than 30 years, but denied personal or family history of cancer. Physical examination on admission disclosed vertebral tenderness. Routine blood examination revealed slightly decreased hemoglobin (HGB, 10.5 g/dL) and platelets (PLT, 87,000/mm3). On chest computed tomography (CT), we observed two lobulated masses measuring 30
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