A rare cause of persistent atelectasis in childhood: Mucoepidermoid carcinoma

A 12-year-old boy presented to our clinic with recurrent lower respiratory tract symptoms that are wheezing, cough, bronchopneumonia, and fever and with a diagnosis of bacterial endocarditis. Physical examination revealed that breath sounds diminished in the left lower lobe. Because cardiac sounds and echocardiography were normal bacterial endocarditis was excluded. Chest radiograph and computerized tomography scan showed a left lower lobe atelectasis and consolidation. Despite medical therapy including antibiotics, bronchodilator etc, atelectasis persisted. Fiberoptic flexible bronchoscopy (FFB) revealed a tumor that totally obstructed the left lower lobe bronchus. Open lung biopsy revealed a low-grade mucoepidermoid carcinoma. Left lower lung lobectomy was performed. The patient is in good condition 12 months after the operation. We proposed that FFB should be performed earlier in patients with recurrent lower respiratory symptoms who have persistent atelectasis or unifocal infiltration.