Mucinous cystadenocarcinoma (MCAC)is an epithelial malignancy of the ovary. This is the first reported case of MCAC presenting as a lung primary.
This 49-year-old woman (25 pack year smoker) presented with a dry cough and shortness of breath onexertion over six months. She was without constitutional symptoms, weight loss or abdominal pain. She had decreased breath sounds over the right chest. A chest xray showed a large mass (ill defined borders) occupying the right upper and mid lung fields.Chest CT scan showed a large cystic lesion encompassing entire right upper lobe extending to the posterior mediastinum and right middle lobe collapse. Bronchoscopy showed extrinsic compression of the posterior trachea and right mainstem bronchus. A right thoracotomy with right upper and middle lobectomy was performed. The pathology showed a mucinous cyst adeno carcinoma with peribronchial lymph node involvement No distant spread of the tumor was found Chemotherapy was started and clinical followup is ongoing.DISCUSSION: This woman presented with a unique case of MCAC of the lung. The differential diagnosis of the cystic lesion included bronchogenic or pericardial cyst, esophageal duplication cyst, neurenteric cyst, and Echinococcus cyst. While usually asymptomatic in nature, each of these may present with symptoms similar to this patient (namely, cough). MCAC has not previously been reported to present with the lung as a primary site. It is an epithelial ovarian malignancy and can be of a serous or mucinous variety. Spread of the tumor to the abdominal cavity, diaphragmatic surface and pleura has been reported.
This is the first reported case of MCAC presenting as a lung primary. Such an entity should be considered in a patient presenting with a cystic lesion of the lung.
K.R. Salahudeen, None.