Tracheal epithelial-myoepithelial carcinoma associated with sarcoid-like reaction: A case report

Abstract

Epithelial-myoepithelial carcinomas are rare tumors that primarily originate in the salivary glands but have also been found in the tracheobronchial tree. We report the first case of epithelial-myoepithelial carcinoma associated with sarcoidosis. A 61 year old Hispanic man presented with altered mental status and hypercalcemia. Imaging revealed diffuse intra-thoracic and intra-abdominal lymphadenopathy. A diagnostic bronchoscopy was performed where an incidental tracheal nodule was discovered and biopsied. Pathology was consistent with epithelial-myoepithelial carcinoma. Lymph node biopsy demonstrated non-caseating granulomas consistent with sarcoidosis. Patient underwent tracheal resection of the primary tumor with primary tracheal reconstruction. Hypercalcemia subsequently normalized with clinical improvement. Repeat CT imaging demonstrated complete resolution of lymphadenopathy. Our findings are suggestive of a possible paraneoplastic sarcoid-like reaction to the epithelial-myoepithelial carcinoma with associated lymphadenopathy and symptomatic hypercalcemia.

Prognosis of primary tracheal tumor: A population‐based analysis

“…Besides diagnosis, the treatments of tracheal tumor remained controversial. Although case reports, reviews and surgical techniques of tracheal tumor have been published, neither large‐scale retrospective studies has been reported, nor consensus on whether they should be treated by the thoracic surgeon or head and neck surgeon has been reached. Even if the surgical treatments has been applied, they would be various without any standard due to the absence of classification.…”

A Case Report of Multiple Lymph Node Metastatic Adenocarcinoma Without Primary Lesion (Probable Source of Salivary Glands)

“…Pulmonary epithelial-myoepithelial Carcinoma are very rare. Because of their origin from the tracheobronchial submucosal glands, pulmonary Epithelial-Myoepithelial Carcinoma are often central lesions that present as endobronchial tumor masses [7][8][9][10][11][12]. As a result, patients commonly present with signs and symptoms of bronchial obstruction, including shortness of breath, cough, hemopt-ysis, chest pain, fever, or pneumonia [13].…”