Digital illustration of a lung with a cavity, representing rare lung cancer.

Lung Cancer Mystery: A Rare Case of Cavity-Forming Carcinoma

Elliot Brynn monogram
Elliot Brynn in Health & Wellness October 2026 • 4 min read.

"Doctors report an unusual case of epithelial-myoepithelial carcinoma (EMC) in the lung, presenting as a cavitary lesion."


Lung cancer often presents in varied and complex ways, making diagnosis a continuous challenge for medical professionals. While many types of lung cancers are well-documented, rare forms occasionally emerge, defying typical expectations and requiring novel approaches to treatment. Among these rarities is epithelial-myoepithelial carcinoma (EMC), a type of cancer predominantly found in the salivary glands.

However, in extremely rare instances, EMC can originate in the lung's bronchial glands. Adding another layer of complexity, lung cancers sometimes develop cavities—hollow spaces within the tumor. Though cavitation is not uncommon in lung cancer, the combination of EMC with a cavitary lesion is exceptionally rare. In fact, medical literature has, until recently, lacked documented cases of this unusual presentation.

A recent case study published in Molecular and Clinical Oncology sheds light on this phenomenon, detailing the diagnosis and treatment of a 72-year-old man with cavity-forming pulmonary EMC. This report not only expands our understanding of lung cancer's diverse manifestations but also highlights the importance of considering rare possibilities in diagnosis.

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Pulmonary EMC: A Rare Salivary-Type Tumor

Pulmonary epithelial-myoepithelial carcinoma (EMC) is a rare lung tumor that originates in bronchial glands or submucosal glands and shares histopathological characteristics with salivary-gland EMC. The Cureus review describes it as typically a low-grade malignancy. Salivary-gland EMC most often arises in the parotid and submandibular glands, according to the 2026 case report. Peripheral pulmonary EMC is described as extremely rare; the cited surgical report also says that multiple primary pulmonary EMC had not been reported at the time of publication.

What is Epithelial-Myoepithelial Carcinoma (EMC)?

Digital illustration of a lung with a cavity, representing rare lung cancer.

Epithelial-myoepithelial carcinoma (EMC) is a rare type of cancer that typically starts in the salivary glands. These glands, located in the mouth and throat, produce saliva to keep the mouth moist and aid in digestion. EMC is characterized by its unique biphasic structure, meaning it has two distinct types of cells:

This dual composition is a key characteristic that helps pathologists identify EMC under a microscope. While EMC is more commonly found in the salivary glands, it can, in rare instances, occur in other parts of the body, such as the respiratory tract.

  • Epithelial cells: These cells form the inner layer of the tumor and often appear as duct-like structures.
  • Myoepithelial cells: These cells surround the epithelial cells and have a clear appearance. They play a role in supporting the structure of the glands.
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Dual Cellular Differentiation

A 2021 WHO Classification of Tumors account characterizes pulmonary epithelial-myoepithelial carcinoma (P-EMC) as showing dual differentiation. Its luminal epithelial-lineage cells form ducts, while basal contractile myoepithelial elements surround them. The source notes that this pattern is characteristic of salivary-gland malignancies.

Unresolved Diagnosis and Management

The available sources identify important uncertainties in pulmonary epithelial-myoepithelial carcinoma (P-EMC). One case report says optimal treatment methods and follow-up periods have not been established, citing the tumor’s unproven malignant potential. Another source cautions that imaging features, including tumor distribution and morphology, remain uncertain because reported cases are limited. These sources therefore do not establish a standard treatment or reliable imaging profile.

When EMC occurs in the lung, it originates from the bronchial glands, which are similar to salivary glands but located in the airways of the lungs. Lung EMC is exceedingly rare, accounting for only a tiny fraction of all primary lung cancers. Due to its rarity, each new case provides valuable insights into its behavior and optimal treatment strategies.

Implications and Future Directions

This rare case of cavity-forming pulmonary EMC underscores the importance of considering unusual presentations of lung cancer. While the mechanism behind cavity formation in this specific case remains unclear, the report suggests that it may be linked to pre-existing cystic lesions in the lung. Further research is needed to fully understand the development and behavior of lung EMC, which could lead to more effective diagnostic and treatment approaches for this rare cancer.

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Rare Cases in Different Lung Locations

A 2015 report describes pulmonary epithelial-myoepithelial carcinoma (EMC) as a minor subtype among rare primary salivary gland-type lung tumors. It documents a case in which EMC occluded the B8 segment of the left lung in a 72-year-old woman. The same source also refers to a very rare case located in the peripheral left lower lobe. These examples illustrate the uncommon occurrence of the tumor in distinct lung locations, rather than establishing how often either presentation occurs.

How often smoking history appeared in cavity-forming lung cancer

  • 36.4% and 66.4%Smoking history was reported in 36.4% of cavitary lung cancer patients, compared with 66.4% of patients with cavitary lung adenocarcinoma in a cited report. These figures describe different groups, not pulmonary EMC.[1]

How cavity findings compare with broader lung-cavity reports

In a study of solitary lung cavities, average maximum wall thickness was 15.2 mm for malignant cases and 7.8 mm for non-malignant cases; average lesion diameter was 51 mm and 35 mm, respectively. These are group comparisons, not measurements that establish the nature of an individual cavity.[2]

What remains uncertain about pulmonary EMC

  • How much can scan appearance distinguish pulmonary EMC from other lung tumors when the reported distribution and morphology remain uncertain?[3]
  • How does the tumor behave over time, given the limited follow-up and evidence that pulmonary examples can infiltrate and metastasize?[4] [5]

Sources

  1. Clinicopathological characteristics of solitary cavitary lung cancer: a case-control study (pmc.ncbi.nlm.nih.gov)
  2. Solitary lung cavities: CT findings in malignant and non-malignant disease. (pubmed.ncbi.nlm.nih.gov)
  3. Pulmonary Epithelial-Myoepithelial Carcinoma (pmc.ncbi.nlm.nih.gov)
  4. Primary Epithelial Myoepithelial Carcinoma of Lung, Reporting of a Rare Entity, Its Molecular Histogenesis and Review of the Literature (pmc.ncbi.nlm.nih.gov)
  5. Pulmonary epithelial-myoepithelial carcinoma: a clinicopathologic and immunohistochemical study of 5 cases. (pubmed.ncbi.nlm.nih.gov)

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

Everything You Need To Know

1

What exactly is Epithelial-myoepithelial carcinoma (EMC)?

Epithelial-myoepithelial carcinoma (EMC) is a rare form of cancer, typically found in the salivary glands, characterized by a unique dual structure. It's composed of Epithelial cells, forming duct-like structures, and Myoepithelial cells, which support the gland's structure. In the lung, EMC is exceedingly rare and originates from the bronchial glands.

2

Why is the discovery of a cavity-forming Epithelial-myoepithelial carcinoma (EMC) significant?

The presentation of a cavity-forming epithelial-myoepithelial carcinoma (EMC) is exceptionally rare. Cavitation, the formation of hollow spaces within a tumor, is not uncommon in lung cancers. However, the combination of EMC and a cavitary lesion is what makes this case particularly unusual and significant. This rarity underscores the importance of considering diverse presentations in cancer diagnosis.

3

What are the implications of this rare form of lung cancer?

In the context of this case, understanding the implications is key. The rare occurrence of Epithelial-myoepithelial carcinoma (EMC) in the lung, particularly when presenting with cavitation, expands the current knowledge of lung cancer's diverse manifestations. Each new case provides valuable insights into its behavior and optimal treatment strategies. This knowledge can contribute to better diagnostic approaches.

4

What is the potential reason behind cavity formation in this case?

The case suggests that pre-existing cystic lesions may be linked to the formation of cavities in the case of epithelial-myoepithelial carcinoma (EMC). However, the precise mechanism remains unclear. Further research is vital to fully comprehend the development and behavior of lung EMC. This research could lead to more effective diagnostic and treatment approaches for this rare cancer.

5

How can a deeper understanding of Epithelial-myoepithelial carcinoma (EMC) improve patient care?

A better understanding of Epithelial-myoepithelial carcinoma (EMC) could lead to more effective diagnostic and treatment approaches. This includes the potential for earlier and more accurate diagnoses. The development of targeted therapies could improve patient outcomes. Further research into the underlying causes of EMC, particularly the mechanisms of cavity formation, can significantly improve patient care.

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