Lung malignancy mimicking adult onset asthma: BMJ case repor
Mucoepidermoid carcinoma (MEC) is a rare tumour of the trachea accounting for up to 0.2% of reported primary lung malignancy.

Herein, the authors report a case of a 54-year-old man, ex-smoker, whose presentation mimicked adult onset asthma with cough and wheezing, which did not respond to conventional treatment. He had occasional haemoptysis and weight loss in which CT scan performed for malignancy screening showed a protruding mass in the distal trachea causing endobronchial obstruction.

Bronchoscopic intervention was performed to relieve the obstruction that resulted in resolution of asthmatic symptoms. Histological diagnosis confirmed MEC.

This case emphasised the importance of a high index of suspicion in an unusual presentation of a common disease and the pivotal role of bronchoscopic intervention in malignant central airway obstruction.

Learning points
• Patients with asthmatic symptoms who failed to respond to medications warrants further investigations, for example, CT thorax or bronchoscopy to look for alternative diagnosis.

• Mucoepidermoid carcinoma is a rare tumour that may present with obstructive airway symptoms leading to misdiagnosis of asthma.

• Bronchoscopic intervention has a significant role in management of malignant airway obstruction.

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