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Fully robotic circumferential resection for midtracheal mucoepidermoid carcinoma : a report of 2 cases

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Abstract
Background: Tracheobronchial mucoepidermoid carcinoma (MEC) is a salivary-gland type of lung cancer that originates from the submucosal glands of the tracheobronchial tree. MECs are rare, constituting 0.1% to 1.0% of lung carcinomas. Recent advancements in minimally invasive techniques allow for complete robotic resection of tracheal MECs. Case Description: Two cases are described in which patients underwent complete robotic thoracoscopic resection for the treatment of a tracheal MEC. Both patients, aged 14 and 28 years, with no significant medical history, presented with symptoms of hemoptysis and dyspnea on exertion. For both patients, spirometry revealed a flow volume loop indicative of intrathoracic central airway obstruction, computed tomography (CT) scans showed a midtracheal tumor and rigid bronchoscopy was performed for tumor debulking, confirming the pathological diagnosis of low-grade MEG. Multidisciplinary discussion led to the decision to proceed with primary surgical resection. In both cases, a circumferential tracheal resection with intrathoracic end-to-end anastomosis under veno-venous extracorporeal membrane oxygenation (VV-ECMO) was performed via a fully robotic approach. There were no intraoperative complications. One patient required re-intervention via open approach due to positive resection margins on paraffinembedded sections despite a negative frozen section peroperatively. Both patients had an uncomplicated recovery with discharge on postoperative days 7 and 4, respectively. The 30-day follow-up showed normal flexible bronchoscopy. The patients had no evidence of recurrence at 5-year (patient 1) and 1-year (patient Conclusions: A fully robotic thoracoscopic approach for midtracheal tumor resection under VV-ECMO is feasible, pending negative margins. Peroperative flexible bronchoscopy is essential to mark the lesion after endotracheal debulking. Multidisciplinary discussion is essential in the decision-making process for the treatment of MEC.
Keywords
Mucoepidermoid carcinoma (MEC), tracheal disease, thoracic oncology, robotic surgery, case report, TRACHEAL RESECTION, RECONSTRUCTION, CANCER, EXPERIENCE, PROGNOSIS, FEATURES

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MLA
Marquenie, Nees, et al. “Fully Robotic Circumferential Resection for Midtracheal Mucoepidermoid Carcinoma : A Report of 2 Cases.” AME CASE REPORTS, vol. 9, 2025, doi:10.21037/acr-2025-121.
APA
Marquenie, N., Malfait, T., De Somer, F., & Desender, L. (2025). Fully robotic circumferential resection for midtracheal mucoepidermoid carcinoma : a report of 2 cases. AME CASE REPORTS, 9. https://doi.org/10.21037/acr-2025-121
Chicago author-date
Marquenie, Nees, Thomas Malfait, Filip De Somer, and Liesbeth Desender. 2025. “Fully Robotic Circumferential Resection for Midtracheal Mucoepidermoid Carcinoma : A Report of 2 Cases.” AME CASE REPORTS 9. https://doi.org/10.21037/acr-2025-121.
Chicago author-date (all authors)
Marquenie, Nees, Thomas Malfait, Filip De Somer, and Liesbeth Desender. 2025. “Fully Robotic Circumferential Resection for Midtracheal Mucoepidermoid Carcinoma : A Report of 2 Cases.” AME CASE REPORTS 9. doi:10.21037/acr-2025-121.
Vancouver
1.
Marquenie N, Malfait T, De Somer F, Desender L. Fully robotic circumferential resection for midtracheal mucoepidermoid carcinoma : a report of 2 cases. AME CASE REPORTS. 2025;9.
IEEE
[1]
N. Marquenie, T. Malfait, F. De Somer, and L. Desender, “Fully robotic circumferential resection for midtracheal mucoepidermoid carcinoma : a report of 2 cases,” AME CASE REPORTS, vol. 9, 2025.
@article{01KKTP5BPXGMAFQJY5BR2YWHFK,
  abstract     = {{Background: Tracheobronchial mucoepidermoid carcinoma (MEC) is a salivary-gland type of lung cancer that originates from the submucosal glands of the tracheobronchial tree. MECs are rare, constituting 0.1% to 1.0% of lung carcinomas. Recent advancements in minimally invasive techniques allow for complete robotic resection of tracheal MECs. Case Description: Two cases are described in which patients underwent complete robotic thoracoscopic resection for the treatment of a tracheal MEC. Both patients, aged 14 and 28 years, with no significant medical history, presented with symptoms of hemoptysis and dyspnea on exertion. For both patients, spirometry revealed a flow volume loop indicative of intrathoracic central airway obstruction, computed tomography (CT) scans showed a midtracheal tumor and rigid bronchoscopy was performed for tumor debulking, confirming the pathological diagnosis of low-grade MEG. Multidisciplinary discussion led to the decision to proceed with primary surgical resection. In both cases, a circumferential tracheal resection with intrathoracic end-to-end anastomosis under veno-venous extracorporeal membrane oxygenation (VV-ECMO) was performed via a fully robotic approach. There were no intraoperative complications. One patient required re-intervention via open approach due to positive resection margins on paraffinembedded sections despite a negative frozen section peroperatively. Both patients had an uncomplicated recovery with discharge on postoperative days 7 and 4, respectively. The 30-day follow-up showed normal flexible bronchoscopy. The patients had no evidence of recurrence at 5-year (patient 1) and 1-year (patient Conclusions: A fully robotic thoracoscopic approach for midtracheal tumor resection under VV-ECMO is feasible, pending negative margins. Peroperative flexible bronchoscopy is essential to mark the lesion after endotracheal debulking. Multidisciplinary discussion is essential in the decision-making process for the treatment of MEC.}},
  articleno    = {{158}},
  author       = {{Marquenie, Nees and Malfait, Thomas and De Somer, Filip and Desender, Liesbeth}},
  issn         = {{2523-1995}},
  journal      = {{AME CASE REPORTS}},
  keywords     = {{Mucoepidermoid carcinoma (MEC),tracheal disease,thoracic oncology,robotic surgery,case report,TRACHEAL RESECTION,RECONSTRUCTION,CANCER,EXPERIENCE,PROGNOSIS,FEATURES}},
  language     = {{eng}},
  pages        = {{10}},
  title        = {{Fully robotic circumferential resection for midtracheal mucoepidermoid carcinoma : a report of 2 cases}},
  url          = {{http://doi.org/10.21037/acr-2025-121}},
  volume       = {{9}},
  year         = {{2025}},
}

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