Pediatric tracheobronchial mucoepidermoid carcinoma (MEC), also called pulmonary MEC, is a rare malignant primary lung neoplasm that is typically found in the large airways. Patients may present with symptoms such as cough, pneumonia, fever, hemoptysis, dyspnea, wheezing, chest pain, weight loss, and fatigue. These nonspecific symptoms (or lack of symptoms in some cases) often result in a delayed diagnosis. Chest CT typically demonstrates findings consistent with bronchial obstruction and diagnosis is made via histopathology. Surgical resection is the mainstay of treatment and children often have favorable outcomes. Here we present four cases of tracheobronchial MEC in children treated at three different hospitals. Our cases highlight the importance of having a broad differential that includes tracheobronchial MEC when a patient does not respond as expected to treatments such as inhaled steroids or antibiotics, and especially if the patient has hemoptysis and/or weight loss. As the use of pediatric interventional pulmonology becomes more common, we may see interventional pulmonology techniques utilized in the diagnosis and management of tracheobronchial MEC. • Tracheobronchial MEC requires a high index of suspicion for a timely diagnosis • Hemoptysis, weight loss, and respiratory symptoms warrant cross-sectional imaging • Interventional pulmonology may be used to diagnose tracheobronchial MEC • Interventional pulmonology may aid in the management of tracheobronchial MEC • Further studies on the use of interventional pulmonology in pediatrics are needed
Hendra et al. (Sun,) studied this question.