Mucoepidermoid bronchial tumors: a review of 34 operated cases.

OBJECTIVE: Pulmonary mucoepidermoid tumors are commonly included with adenoid cystic carcinoma and carcinoid tumors under the misleading rubric 'bronchial adenomas'. These neoplasms are extremely rare and little is known about their oncologic behaviour. They are considered to be of high, or low malignancy.
METHODS: During a 16-year-period 34 consecutive patients (24 male and 10 female with an average age of 53 years) underwent surgery for pulmonary mucoepidermoids in our clinic (0.5% of all resected lung tumors). Fourteen patients were complaint free, in the others obstructive symptoms dominated. In 23 patients the tumors were located in the upper lobes. In 24 cases lobectomy, in four instances limited resection and in six cases pneumonectomy were performed without hospital mortality.
RESULTS: Twenty-nine tumors proved to be high grade and five low grade malignancy by histology. In the latest group the 5-year-survival amounted to 80% (all of these tumors were observed in stage T1-2 N0), on the other hand, however, that rate accounted only 31% at high grade malignant mucoepidermoids. There was no 5-year-survivor among patients having N2-disease (n=5).
CONCLUSION: Mucoepidermoid tumors have to be treated by radical surgery with lymph node sampling and dissection. Patients with low grade tumors can be expected to be cured following complete resection, on the other hand, however, in cases of high grade malignant neoplasms surgery results in significantly worse prognosis. Careful histological typing plays a key role in prediction of late results.