Mucoepidermoid carcinoma of the trachea and bronchus: the case for conservative resection

We report our experience with 5 patients with mucoepidermoid carcinoma treated by conservative resection, and review the literature on the 62 patients previously reported. A visual bronchoscopic diagnosis of adenoma was made in all 5 current patients. Bronchoscopic biopsy was performed in 4 and provided an accurate histological diagnosis in each. Conservative resection was accomplished with bronchoplastic techniques in 4 patients: sleeve lobectomy, 2; lobectomy with plastic bronchial closure, 1; and segmental tracheal resection, 1. The other patient underwent conventional lobectomy. All 5 patients are alive and free from disease 4 to 15 years following operation. The recently demonstrated correlation between histological grading and clinical behavior allows relatively benign variants of mucoepidermoid tumors to be accurately identified by bronchoscopic biopsy prior to thoracotomy. Because these tumors have a propensity to originate centrally in the tracheobronchial tree, bronchoplastic procedures frequently are required in order to accomplish tumor extirpation with limited pulmonary resection.