1
|
Ricaurte LM, Arrieta O, Zatarain-Barrón ZL, Cardona AF. Comprehensive review of fetal adenocarcinoma of the lung. LUNG CANCER (AUCKLAND, N.Z.) 2018; 9:57-63. [PMID: 30197546 PMCID: PMC6112786 DOI: 10.2147/lctt.s137410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Fetal adenocarcinoma of the lung (FLAC) is a rare tumor. It accounts for ~0.1%-0.5% of all pulmonary neoplasms. Due to its rarity, much of the world literature regarding FLAC comes from case reports and case series. FLAC is an adenocarcinoma resembling developing fetal lung in its pseudoglandular stage (8-16 weeks of gestation). It is distinguishable from pulmonary blastoma (PB) because it lacks the mesenchymal component which is a hallmark finding in PB. Due to differences in histopathology and clinical course, FLAC has been further categorized into low-grade (L-FLAC) and high-grade (H-FLAC) forms. L-FLAC displays low nuclear atypia and prominent morule formation and has a pure pattern. H-FLAC typically presents with at least 50% fetal morphology, and is often associated with other conventional types of lung adenocarcinoma. FLAC expresses neuroendocrine markers and thyroid transcription factor 1 in most cases. L-FLAC has an aberrant nuclear/cytoplasmic expression of β-catenin and presents mutations in this gene. H-FLAC overexpresses p53. These tumors have a very low frequency of mutations in KRAS and EGFR; it is thought that they are different from a molecular point of view to conventional lung adenocarcinomas. Approximately 25%-40% of patients are asymptomatic at presentation; most of them are incidental findings on chest radiographs. H-FLAC is more common in elderly male patients, with a heavy smoking history. L-FLAC tends to occur in young females. Patients with L-FLAC are usually diagnosed with stage I-II disease, while patients with H-FLAC usually present with a more advanced-stage disease. Poor prognostic factors for FLAC are thoracic lymphadenopathy, metastases at diagnosis, and tumor recurrence; however, the 10-year survival for FLAC is estimated at 75%.
Collapse
Affiliation(s)
| | - Oscar Arrieta
- Thoracic Oncology Unit, National Cancer Institute (INCan), México City, México
| | | | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia,
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia,
| |
Collapse
|
2
|
Tartarone A, Romano G, Galasso R, Coccaro M, Cammarota A, Sgambato A, Bochicchio A. Pulmonary Blastoma after Liver Transplant: A Case Report. TUMORI JOURNAL 2018; 88:173-5. [PMID: 12088262 DOI: 10.1177/030089160208800219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
There is an increased risk of cancer after organ transplantation mainly due to the immunosuppressive therapy required in these patients. We report a case of biphasic pulmonary blastoma in an adult male who underwent liver transplant for hepatocellular carcinoma in March 1999, followed by immunosuppressive treatment and adjuvant chemotherapy with epirubicin. Disease-free survival lasted 18 months, then a diagnosis of biphasic pulmonary blastoma was made and the patient underwent a lung lobectomy. Five months after surgical resection a recurrence of this rare tumor was recorded and two cycles of cisplatin + etoposide and ifosfamide + etoposide and one cycle of second-line chemotherapy with vinorelbine were administered. The tolerability and the efficacy of this treatment were poor. The patient died less than one year after diagnosis. To our knowledge this is the first reported case of pulmonary blastoma in a transplant patient. Our findings confirm that organ transplant recipients deserve long-term medical surveillance also in the absence of graft complications, and that pulmonary blastoma is an aggressive tumor with a poor prognosis.
Collapse
Affiliation(s)
- Alfredo Tartarone
- Department of Medical Oncology, Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture (PZ), Italy.
| | | | | | | | | | | | | |
Collapse
|
3
|
Das M, Maity Chaudhuri P, Bandyopadhyay A, Chatterjee U. Pulmonary blastoma in a child: Report of a case with cytological findings. Diagn Cytopathol 2017; 46:175-178. [DOI: 10.1002/dc.23811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 08/23/2017] [Accepted: 08/28/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Mou Das
- Department of Pathology; IPGME&R; Kolkata India
| | | | | | | |
Collapse
|
4
|
Zhao YY, Liu L, Zhou T, Zhou NN, Yang YP, Hou X, Li Y, Zhao HY, Huang Y, Zhang L. A retrospective analysis of the clinicopathological and molecular characteristics of pulmonary blastoma. Onco Targets Ther 2016; 9:6915-6920. [PMID: 27877056 PMCID: PMC5108598 DOI: 10.2147/ott.s117097] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this study was to analyze and summarize the clinicopathological and molecular characteristics of classic biphasic pulmonary blastoma (PB) to improve its diagnosis and treatment. Patients and methods A retrospective analysis was performed in patients who were diagnosed with PB at Sun Yat-Sen University Cancer Center from March 1995 to March 2015. Genomic DNA was profiled using a capture-based targeted sequencing panel. Results Sixteen patients with an average age of 40 years were included in this study. Accurate preoperative diagnosis was very challenging as surgically resected tissues with immunohistochemical staining were required for the diagnosis. Surgery was the optimal treatment for localized disease and there was no standard management for metastatic disease. Mutations were detected among 9 out of the 56 genes profiled, including BRCA2, ERBB4, ALK, MET, BRAF, RAF1, PTEN, EGFR, and PIK3CA. Conclusion Due to the low incidence rate and the reclassification of PB, no standard treatment is available. Although the numbers of cases are few with varying individual experiences, it is important to improve our understanding regarding this rare lung cancer. Targeted DNA sequencing may be of clinical use for molecular testing and the effects of targeted therapy need to be confirmed.
Collapse
Affiliation(s)
- Yuan-Yuan Zhao
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou
| | - Lin Liu
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou; Department of Medical Oncology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong
| | - Ting Zhou
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou
| | - Ning-Ning Zhou
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou
| | - Yun-Peng Yang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou
| | - Xue Hou
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou
| | - Yong Li
- Department of Pathology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Hong-Yun Zhao
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou
| | - Yan Huang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou
| | - Li Zhang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou
| |
Collapse
|
5
|
Hansra DM, Ponce M, Sandoval-Sus JD, Cioffi-Lavina M, Patel R, Offiong IF, Santos ES. Pulmonary blastoma: a clinicopathologic study of 3 cases and review of literature. Int Cancer Conf J 2015. [DOI: 10.1007/s13691-014-0197-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
6
|
Abstract
Biphasic pulmonary blastoma is a rare malignancy of the lung composed of proliferating epithelial and mesenchymal cells with a high vessel density at the tumor periphery. We report a rare case of renal metastasis of biphasic pulmonary blastoma that responded to sorafenib, an oral multikinase inhibitor. After 2 months of treatment with sorafenib, the renal tumor size decreased sufficiently to allow a safe laparoscopic radical nephrectomy. We believe that further studies are warranted to confirm the possible effects of sorafenib on pulmonary blastomas.
Collapse
Affiliation(s)
- Keerthi Mulamalla
- Division of Hematology, Oncology and Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | | | | |
Collapse
|
7
|
Lee TH, Lee KY, Kim SR, Min KH, Park SJ, Lee HB, Rhee YK, Lee YC. A Case of Huge Pulmonary Blastoma With Multiorgan Invasion. Tuberc Respir Dis (Seoul) 2007. [DOI: 10.4046/trd.2007.62.2.149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Tae Hwan Lee
- Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Ka Young Lee
- Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - So Ri Kim
- Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Kyung Hun Min
- Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Seoung Ju Park
- Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Heung Bum Lee
- Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Yang Keun Rhee
- Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Yong Chul Lee
- Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School, Jeonju, Republic of Korea
| |
Collapse
|
8
|
Liman ST, Altinok T, Topcu S, Tastepe AI, Uzar A, Demircan S, Demirag F. Survival of biphasic pulmonary blastoma. Respir Med 2005; 100:1174-9. [PMID: 16332433 DOI: 10.1016/j.rmed.2005.10.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2005] [Revised: 10/23/2005] [Accepted: 10/25/2005] [Indexed: 01/26/2023]
Abstract
Pulmonary blastoma is a rare malignant lung tumor with a poor prognosis. It is composed of immature mesenchymal and epithelial components that resemble fetal lung tissue. We aimed to share our treatment results in biphasic pulmonary blastoma. In Ataturk Chest Disease and Thoracic Surgery Center, five patients with biphasic pulmonary blastoma (four men, one woman, aged between 27 and 61-mean 39.4) were treated between 1987 and 2000 (0.3% of operated NSCC). Hemoptysis, cough, chest pain and dyspnea were the symptoms. Anemia and high erythrocyte sedimentation rate were determined in two patients. Radiological examinations revealed a mass in four patients and massive pleural effusion in one. None of the patients were diagnosed preoperatively and hence all patients underwent exploratory thoracotomy. Three lobectomy, one pneumonectomy and one wedge resection were performed. Histopathological examinations revealed biphasic pulmonary blastoma in all the patients. Pathological stagings were as follows: 1 patient in T1N0M0 and 1 patient in T2N0M0 (198 and 112 months survival, respectively), three patients in T2N1M0 (9,10,17 months survival). In follow up period, prostate carcinoma and rectum carcinoma were detected as second primary tumors in the patient in stage T2N0M0. In patients who have small size tumors without nodal involvement, long-term survival can be obtained with radical surgery; even in biphasic pulmonary blastomas. According to our limited experiences, N1 nodal involvement shows very poor prognosis.
Collapse
Affiliation(s)
- Serife Tuba Liman
- Thoracic Surgery Department, The Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
| | | | | | | | | | | | | |
Collapse
|
9
|
Surmont VF, van Klaveren RJ, Nowak PJCM, Zondervan PE, Hoogsteden HC, van Meerbeeck JP. Unexpected response of a pulmonary blastoma on radiotherapy: a case report and review of the literature. Lung Cancer 2002; 36:207-11. [PMID: 11955657 DOI: 10.1016/s0169-5002(01)00465-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pulmonary blastoma (PB) is a rare malignant tumor of the lung. Treatment is primarily surgical, although, combination chemotherapy has been reported to result in objective responses in inoperable tumors or after incomplete resections. To our knowledge, this is the first report of a very radiosensitive PB, which showed major tumor reduction after several fractions of radiotherapy without further tumor regression after additional chemotherapy with cisplatin and etoposide. The literature on the treatment of PB is reviewed.
Collapse
Affiliation(s)
- Veerle F Surmont
- Department of Pulmonology, Respiratory Oncology Unit, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.
| | | | | | | | | | | |
Collapse
|
10
|
Cutler CS, Michel RP, Yassa M, Langleben A. Pulmonary blastoma: case report of a patient with a 7-year remission and review of chemotherapy experience in the world literature. Cancer 1998; 82:462-7. [PMID: 9452262 DOI: 10.1002/(sici)1097-0142(19980201)82:3<462::aid-cncr6>3.0.co;2-r] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pulmonary blastoma is a rare malignant neoplasm for which there currently are no treatment guidelines. METHODS A patient with locally advanced pulmonary blastoma is described. The treatment modality is discussed and the world literature is reviewed with respect to the use of chemotherapy. RESULTS A 54-year-old man had a 7-year disease free survival despite subtotal resection. He was treated with adjuvant radiotherapy and combination chemotherapy. Three cycles of cisplatin and etoposide were administered. The world literature was reviewed with regard to the use of adjuvant chemotherapy in the treatment of pulmonary blastoma. CONCLUSIONS Surgery, adjuvant radiotherapy, and combination chemotherapy with cisplatin and etoposide should be considered in the treatment of patients with this rare pulmonary neoplasm.
Collapse
Affiliation(s)
- C S Cutler
- Department of Medical Oncology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada
| | | | | | | |
Collapse
|
11
|
|
12
|
|