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Vol.61 No.3 contents

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- Case Report -

Resection of Synchronous Multiple Ciliated Muconodular Papillary Tumor: a Case Report

Haruna Sawada¹, Ayako Fujiwara¹, Seijitsu Ando², Satoru Miyamoto², Takeshi Kimura², Mitsumasa Ogawara², Kiyoshi Mori³, Atsuo Inoue⁴, Keiko Kuriyama⁴, Koji Takami^1
1Department of Thoracic Surgery, ²Department of Respiratory Medicine, ³Department of Central Laboratory and Surgical Pathology, ⁴Department of Radiology, National Hospital Organization Osaka National Hospital, Japan

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Background. Ciliated muconodular papillary tumor (CMPT) is a rare lesion characterized by the papillary growth of ciliated and goblet cells, making it difficult to distinguish from primary lung adenocarcinoma. Case. A man in his 60s was followed for a 1.3-cm partially solid nodule (solid component diameter: 0.9 cm) in S⁹ of the left lung, as observed on abdominal computed tomography (CT) before surgery for renal cancer. Chest CT at the three-year follow-up examination revealed an increase in the solid diameter of the tumor, while 18F-fluorodeoxyglucose-positron emission tomography showed a low maximum standardized uptake value of 1.1. Primary lung cancer with cT2a (PL1) N0M0 or a metastatic lung tumor from renal cancer was suspected, and the patient underwent surgical resection for a histopathological diagnosis and treatment. A rapid intraoperative histopathological diagnosis from the partial resection specimen revealed primary lung adenocarcinoma; therefore, thoracoscopic left lower lobectomy was performed. In the routine histopathological specimen, cuboidal and columnar epithelial cells arranged in a single layer were found to have replaced the alveolar epithelium, and cilia were observed on the airspace side of the cells. Mucus accumulation was noted in the area corresponding to air space. The final histopathological diagnosis of the nodule was CMPT. In addition, a small 3-mm nodule found in S⁶ of the resected lung showed a similar histology, resulting in a diagnosis of multiple CMPTs. Conclusion. We reported a rare case of simultaneous multiple CMPTs in the same lobe mimicking primary adenocarcinomas with lepidic growth on preoperative CT and an intraoperative histopathological diagnosis.
key words: Ciliated muconodular papillary tumor, Lung adenocarcinoma, Bronchiolar adenoma, Multiple

Received: October 20, 2020
Accepted: March 11, 2021

JJLC 61 (3): 218-224, 2021