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Case Report Open Access

Primary endobronchial epithelial‑myoepithelial carcinoma: A case report and literature review

  • Authors:
    • Dan Cheng
    • Zhou Zhang
    • Ye Zhu
    • Yunyun Wang
    • Tao Ren
    • Jiankun Wang
    • Fei Wang
  • View Affiliations / Copyright

    Affiliations: Department of Blood Transfusion Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China, Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China, Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China, Department of Thoracic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China, Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
    Copyright: © Cheng et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 193
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    Published online on: August 11, 2025
       https://doi.org/10.3892/etm.2025.12943
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Abstract

Pulmonary epithelial‑myoepithelial carcinoma (P‑EMC) is a rare type of salivary gland tumour of the lung. Due to its rarity and lack of long‑term follow‑up data, there is no established standard for optimal treatment or duration of follow‑up. The present study reports the case of a 58‑year‑old female patient with P‑EMC originating from the middle part of the bronchus and presenting as an endobronchial mass in the left superior lobe. Transbronchial forceps biopsy was performed on the visible neoplasm in the left superior lobe, which revealed atypical epithelial cells with a possible diagnosis of mucoepidermoid carcinoma. The patient subsequently underwent left upper lobectomy with mediastinal lymph node dissection. The decision for resection was made based on the absence of abnormalities in the patient's head and neck MRI scan, bone scintigraphy and contrast‑enhanced whole‑body CT scan, along with the consensus reached by the multidisciplinary treatment team. Final histopathology of the resected specimen confirmed P‑EMC. The patient remained free of recurrence and metastasis 5 years post‑surgery. Diagnosis of P‑EMC from transbronchial forceps biopsy samples is difficult due to its rarity, insufficient sampling and dual histological phenotype. The current study reported a rare case of primary P‑EMC initially suspected to be mucoepidermoid carcinoma based on biopsy. Postoperative pathology confirmed the diagnosis of P‑EMC. Based on this case and a literature review, for endobronchial EMC lesions confined to the bronchus measuring <2 cm without metastasis, bronchoscopic intervention or video‑assisted thoracoscopic segmentectomy may be viable therapeutic alternatives. For nonmetastatic central lesions >2 cm, lobectomy or wedge resection should be considered to avoid the more traumatic pneumonectomy whenever possible.
View Figures

Figure 1

Chest CT images. (A) Chest CT
revealed a nodule with a maximum diameter of 0.8 cm in the
bronchial lumen of the upper lobe of the left lung (red arrow); the
hilar and mediastinal lymph nodes were not enlarged. (B)
Contrast-enhanced chest CT scan showed no evidence of recurrence 4
years after surgery. CT, computed tomography.

Figure 2

(A) Bronchoscopy revealed an
endobronchial mass characterized by a smooth neoplasm obstructing
the lumen at the entrance of the left upper lobe (yellow arrow).
(B) Transbronchial forceps biopsy of the neoplasm was performed,
and rapid onsite evaluation identified this neoplasm as non-small
cell lung cancer based on cytological characteristics, including
dyscohesive aggregate cells with large nuclei and prominent
nucleoli (Diff-Quik staining; magnification, x200).

Figure 3

Macroscopic and histopathological
examination of the surgically resected specimen. (A)
Macroscopically, the size of the removed upper lobe of the left
lung was 11.5x8.5x4 cm. A mass measuring 1.2x1x0.8 cm, located 0.6
cm from the bronchial stump, was observed in the bronchial lumen
(red circle). The cut surface was grey-white, solid, hard and
nodular, with distinct borders from the surrounding tissue. The
remaining lung tissue was grey-red and soft. (B) Histologically,
the tumour exhibited a biphasic pattern, with inner ductal cells
(black arrow) surrounded by clear myoepithelial cells (yellow
arrow) and showing partial squamous differentiation (green arrow)
(H&E staining; magnification, x200).

Figure 4

Immunohistochemical staining. (A) The
inner epithelial component (black arrow) was strongly positive for
cytokeratin 7. (B and C) The myoepithelial cells (black arrows)
showed weak focal positivity for (B) S-100 and (C) SOX10. (D)
Vimentin positivity was observed in myoepithelial cells (black
arrow). (E) P40 positivity (black arrow) was observed in both
myoepithelial cells and cells exhibiting squamous differentiation.
(F) Thyroid transcription factor 1 was weakly positive (black
arrow) in most cells (magnification, x200; scale bars, 50 µm).
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Copy and paste a formatted citation
Spandidos Publications style
Cheng D, Zhang Z, Zhu Y, Wang Y, Ren T, Wang J and Wang F: Primary endobronchial epithelial‑myoepithelial carcinoma: A case report and literature review. Exp Ther Med 30: 193, 2025.
APA
Cheng, D., Zhang, Z., Zhu, Y., Wang, Y., Ren, T., Wang, J., & Wang, F. (2025). Primary endobronchial epithelial‑myoepithelial carcinoma: A case report and literature review. Experimental and Therapeutic Medicine, 30, 193. https://doi.org/10.3892/etm.2025.12943
MLA
Cheng, D., Zhang, Z., Zhu, Y., Wang, Y., Ren, T., Wang, J., Wang, F."Primary endobronchial epithelial‑myoepithelial carcinoma: A case report and literature review". Experimental and Therapeutic Medicine 30.4 (2025): 193.
Chicago
Cheng, D., Zhang, Z., Zhu, Y., Wang, Y., Ren, T., Wang, J., Wang, F."Primary endobronchial epithelial‑myoepithelial carcinoma: A case report and literature review". Experimental and Therapeutic Medicine 30, no. 4 (2025): 193. https://doi.org/10.3892/etm.2025.12943
Copy and paste a formatted citation
x
Spandidos Publications style
Cheng D, Zhang Z, Zhu Y, Wang Y, Ren T, Wang J and Wang F: Primary endobronchial epithelial‑myoepithelial carcinoma: A case report and literature review. Exp Ther Med 30: 193, 2025.
APA
Cheng, D., Zhang, Z., Zhu, Y., Wang, Y., Ren, T., Wang, J., & Wang, F. (2025). Primary endobronchial epithelial‑myoepithelial carcinoma: A case report and literature review. Experimental and Therapeutic Medicine, 30, 193. https://doi.org/10.3892/etm.2025.12943
MLA
Cheng, D., Zhang, Z., Zhu, Y., Wang, Y., Ren, T., Wang, J., Wang, F."Primary endobronchial epithelial‑myoepithelial carcinoma: A case report and literature review". Experimental and Therapeutic Medicine 30.4 (2025): 193.
Chicago
Cheng, D., Zhang, Z., Zhu, Y., Wang, Y., Ren, T., Wang, J., Wang, F."Primary endobronchial epithelial‑myoepithelial carcinoma: A case report and literature review". Experimental and Therapeutic Medicine 30, no. 4 (2025): 193. https://doi.org/10.3892/etm.2025.12943
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