A Case of sleeve resection of left main bronchus for bronchial mucoepidermoid carcinoma

A 17-year-old female complained of dyspnea and left chest pain. Chest film revealed complete atelectasis of the left lung. The bronchofiberscopic examination revealed an endobronchial lesion causing a massive obstruction of the left main bronchus, and based on biopsy results, we made a diagnosis of mucoepidermoid carcinoma. Prior to the operation, bronchofiberscopic electrosurgery was performed under general anesthesia, and partial resection of the tumor took place using an electrosurgical snare. This procedure enables observation of the distal part of the left main bronchus. Observation of the distal side of the tumor showed that the tumor originated from the mediastinal side of the left main bronchus and the tumor base was limited to the left main bronchus. Thus, it was possible to perform a sleeve resection of the left main bronchus along with the surrounding healthy bronchial tissue without losing lung parenchyma. We reconstructed the left main bronchus with end to end anastomosis after the resected edges were proven to be tumor-free by frozen section. The resected specimen originating in the left main bronchus and the tissue protruding to the endobronchial lumen were diagnosed as mucoepidermoid carcinoma grade II, according to Conlan's classification.