Diagnostic and surgical challenges of pulmonary mucoepidermoid carcinoma: a case report

Pulmonary mucoepidermoid carcinoma (MEC) is a rare salivary gland-type tumour often associated with delayed diagnosis due to nonspecific findings. We report a 75-year-old woman with chronic respiratory symptoms initially treated as asthma without improvement. Computed tomography showed a left hilar lesion with post-obstructive changes and apparent compression of the left main and lower bronchi, suggesting extensive hilar involvement. Bronchoscopic and endobronchial ultrasound-guided biopsies were nondiagnostic despite persistent airway obstruction. Surgical exploration revealed a localized intrabronchial tumour arising from the left lower lobe bronchus. A left lower sleeve lobectomy with preservation of the upper lobe was successfully performed, avoiding pneumonectomy. Histopathology confirmed a 22-mm low-grade MEC with negative margins and no nodal involvement. The postoperative recovery was favorable. This case highlights the diagnostic challenges of pulmonary MEC and the value of parenchymal-sparing surgery in selected patients with central airway tumours.