1
|
Chen Y, Chen H, Yu R, Zeng X, Tian D, Pu Q, Liu Y. Pulmonary blastoma is successfully treated with immunotherapy and targeted therapy. Lung Cancer 2024; 189:107476. [PMID: 38280290 DOI: 10.1016/j.lungcan.2024.107476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/29/2024]
Abstract
Pulmonary blastomas (PB) are an extremely rare type of lung cancer. Currently, no standard treatment exists for PB. Immunotherapy with checkpoint inhibitors and anti-angiogenesis treatments has been an effective method for lung cancer; however, studies on PB treatment are lacking. Herein, we present a case report of successful conversion therapy with immunotherapy and targeted therapy for PB. After receiving treatment with a PD-1 inhibitor (penpulimab) and a multi-target tyrosine kinase inhibitor (anlotinib) treatment, the patient showed an impressive response and underwent a successful operation. We also summarized and reviewed literature reports on PubMed from January 1, 2000, to December 31, 2022, using the keyword "pulmonary blastoma", discussing the efficacy and specifics of chemotherapy and radiotherapy. Immunotherapy, in combination with targeted therapy, should be considered a potential therapeutic strategy for PB.
Collapse
Affiliation(s)
- Yicong Chen
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Huijiao Chen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ruixuan Yu
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoxiao Zeng
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China; Department of Oncology, The People's Hospital of Jianyang City, Jianyang, Sichuan 641400, China
| | - Dong Tian
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Pu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yongmei Liu
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
| |
Collapse
|
2
|
Xie Y, Su N, Li C, Lei A, Li L, Zou J, Cen W, Hu J. Pulmonary blastoma treatment response to anti-PD-1 therapy: a rare case report and literature review. Front Oncol 2023; 13:1146204. [PMID: 37124510 PMCID: PMC10130361 DOI: 10.3389/fonc.2023.1146204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/28/2023] [Indexed: 05/02/2023] Open
Abstract
Pulmonary blastoma (PB) is a rare and invasive malignancy of the lungs with a poor prognosis. Although the mainstay treatment of PB is surgery, and radiotherapy and chemotherapy have been reported, no standard therapy exists for patients inoperable in advanced stages. Moreover, little is known about driver mutation status and immunotherapy efficacy. This paper presents a male patient diagnosed with classic biphasic PB using CT-guided lung biopsy pathology and immunohistochemistry. The patient's symptoms included cough, chest pain, shortness of breath, hemoptysis, and hypodynamia. The primary focus of this paper is to discuss the impact of anti-PD-1 immunotherapy on PB. The patient experienced progression-free survival (PFS) of over 27 months following sintilimab second-line anti-PD-1 therapy. The patient has currently survived for nearly 40 months with a satisfactory quality of life.
Collapse
Affiliation(s)
- Yalin Xie
- Department of Oncology, Guangzhou Chest Hospital, Guangzhou, China
| | - Ning Su
- Department of Oncology, Guangzhou Chest Hospital, Guangzhou, China
- *Correspondence: Ning Su, ; Jinxing Hu,
| | - Chaoxia Li
- Department of Pathology, Guangzhou Chest Hospital, Guangzhou, China
| | - An Lei
- Department of Oncology, Guangzhou Chest Hospital, Guangzhou, China
| | - Lei Li
- Department of Oncology, Guangzhou Chest Hospital, Guangzhou, China
| | - Jianjun Zou
- Department of Oncology, Guangzhou Chest Hospital, Guangzhou, China
| | - Wencang Cen
- Department of Oncology, Guangzhou Chest Hospital, Guangzhou, China
| | - Jinxing Hu
- Department of Internal Medicine, Guangzhou Chest Hospital, Guangzhou, China
- State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, China
- *Correspondence: Ning Su, ; Jinxing Hu,
| |
Collapse
|
3
|
Bu X, Liu J, Wei L, Wang X, Chen M. Epidemiological features and survival outcomes in patients with malignant pulmonary blastoma: a US population-based analysis. BMC Cancer 2020; 20:811. [PMID: 32847556 PMCID: PMC7449001 DOI: 10.1186/s12885-020-07323-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 08/19/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Pulmonary blastoma (PB) is a rare lung primary malignancy with poorly understood risk factors and prognosis. We sought to investigate the epidemiologic features and long-term outcomes of PB. METHODS A population-based cohort study was conducted to quantify the death risk of PB patients. All subjects diagnosed with malignant PB from 1988 to 2016 were screened from the Surveillance, Epidemiology and End Results database. Cox regression model of all-cause death and competing risk analysis of cause-specific death were performed. RESULTS We identified 177 PB patients with a median survival of 108 months. The 5 and 10-year survival rate in all PB patients were 58.2 and 48.5%, as well as the 5 and 10-year disease-specific mortality were 33.5 and 38.6%. No sex or race disparities in incidence and prognosis was observed. The death risk of PB was significantly associated with age at diagnosis, clinical stage, histologic subtype and surgery treatment (p<0.01). On multivariable regression analyses, older age, regional stage and no surgery predicted higher risk of both all-cause and disease-specific death in PB patients. CONCLUSION We described the epidemiological characteristics of PB and identified its prognostic factors that were independently associated with worse clinical outcome.
Collapse
Affiliation(s)
- Xiang Bu
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.,Key Laboratory of Molecular Cardiology, Xi'an, Shaanxi Province, China
| | - Jing Liu
- Key Laboratory of Molecular Cardiology, Xi'an, Shaanxi Province, China.,Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Linyan Wei
- Key Laboratory of Molecular Cardiology, Xi'an, Shaanxi Province, China.,Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Xiqiang Wang
- Key Laboratory of Molecular Cardiology, Xi'an, Shaanxi Province, China.,Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Mingwei Chen
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
| |
Collapse
|
4
|
Lewis JA, Petty WJ, Urbanic J, Bernstein ED, Ahmed T. Cure of Oligometastatic Classic Biphasic Pulmonary Blastoma Using Aggressive Tri-modality Treatment: Case Series and Review of the Literature. Cureus 2018; 10:e3586. [PMID: 30656089 PMCID: PMC6333266 DOI: 10.7759/cureus.3586] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Pulmonary blastoma is a rare lung cancer classified into three subtypes: classic biphasic pulmonary blastoma (CBPB), well-differentiated fetal adenocarcinoma (WDFA), and pleuropulmonary blastoma (PPB) of childhood. Compared to the other subtypes, CPPB is an aggressive tumor with an overall five-year survival of 16% across all stages. We present two cases of biopsy-proven metastatic CBPB, who have been disease-free for over 10 years since treatment completion. Both patients were treated with surgery to the primary tumor followed by an adjuvant cisplatin-based chemotherapy for four cycles and thoracic radiation. One patient relapsed shortly after the completion of thoracic radiation with brain metastases and underwent craniotomy, gamma knife radiosurgery (GKRS), and whole brain radiation therapy. The other patient presented with synchronous pelvic metastases and underwent metastasectomy after the completion of chemotherapy but before the initiation of thoracic radiation. We review the literature regarding surgical, chemotherapeutic, and radiation treatment for patients with metastatic pulmonary blastoma. Based on our experience and review of the existing case reports, aggressive tri-modality treatment including surgery, chemotherapy with a cisplatin backbone, and a definitive treatment of oligometastatic lesions amenable to local therapy including resection or radiosurgery is reasonable to consider for medically fit patients with CBPB.
Collapse
Affiliation(s)
| | - William J Petty
- Internal Medicine, Wake Forest School of Medicine, Winston-Salem, USA
| | - James Urbanic
- Radiation Oncology, University of California San Diego Moores Cancer Center, San Diego, USA
| | | | - Tamjeed Ahmed
- Internal Medicine, Wake Forest School of Medicine, Winston-Salem, USA
| |
Collapse
|
5
|
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
|
6
|
Nemeh F, Kuo AH, Ross J, Restrepo CS. The Radiologic and Pathologic Diagnosis of Biphasic Pulmonary Blastoma. J Radiol Case Rep 2017; 11:10-21. [PMID: 29299105 PMCID: PMC5743140 DOI: 10.3941/jrcr.v11i9.3153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Pulmonary blastomas are rare malignancies, representing 0.25% to 0.5% of all primary lung neoplasms with often aggressive progression and poor prognosis. Clinical management of pulmonary blastomas depends on histologic subtype, staging, and presentation, and may consist of surgery, chemotherapy, and radiation. Biphasic pulmonary blastoma is a subtype of pulmonary blastoma that exhibits biphasic histology, with both epithelial and mesenchymal malignant elements. We report a case of biphasic pulmonary blastoma in a 33-year-old female with 1 pack per day history of smoking for approximately 16 years, who presented with left-sided pleuritic chest pain on deep inspiration without otherwise significant pat medical history. Imaging evaluation using chest radiography, computed tomography, and magnetic resonance imaging identified a heterogenous, well-circumscribed, left lower lobe mass with extensive necrosis and hemorrhage. No lymphadenopathy or distant metastasis was detected through imaging evaluation. Surgical resection of the tumor followed by histopathological analysis confirmed a biphasic pulmonary blastoma.
Collapse
Affiliation(s)
- Fadi Nemeh
- Department of Radiology, University of Texas Health and Science Center, San Antonio, Texas, USA
| | - Anderson H Kuo
- Department of Radiology, University of Texas Health and Science Center, San Antonio, Texas, USA
| | - Jenny Ross
- Department of Pathology, University of Texas Health and Science Center, San Antonio, Texas, USA
| | - Carlos S Restrepo
- Department of Radiology, University of Texas Health and Science Center, San Antonio, Texas, USA
| |
Collapse
|
7
|
Brodowska-Kania D, Kotwica E, Paturej A, Sośnicki W, Patera J, Giżewska A, Niemczyk S. What do we know about pulmonary blastoma?: review of literature and clinical case report. NAGOYA JOURNAL OF MEDICAL SCIENCE 2016; 78:507-516. [PMID: 28008207 PMCID: PMC5159477 DOI: 10.18999/nagjms.78.4.507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/06/2016] [Indexed: 11/30/2022]
Abstract
Pulmonary blastoma (PB) is a rare form of lung tumour and is accountable for 0.25-0.5% of primary pulmonary malignancies. Initially pulmonary blastoma was divided into three subtypes: biphasic pulmonary blastoma (BPB) consisting of an epithelial and mesenchymal component, well differentiated fetal adenocarcinoma (WDFA) built of well differentiated epithelium and a mesenchymal component and malignant pleuropulmonary blastoma (PPB). Prognosis in this type of cancer is really poor. We present a current review of literature and a clinical case report. Treatment of PB is very difficult. Data and recommendations about the treatment of pulmonary blastoma are still available therefore we should use only observations and clinical case reports.
Collapse
Affiliation(s)
- Dorota Brodowska-Kania
- Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland
| | - Ewa Kotwica
- Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland
| | - Aleksandra Paturej
- Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland
| | - Witold Sośnicki
- Department of General Surgery, Oncology, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Janusz Patera
- Department of Pathology, Military Institute of Medicine, Warsaw, Poland
| | - Agnieszka Giżewska
- Department of Nuclear Medicine, Military Institute of Medicine, Warsaw, Poland
| | - Stanisław Niemczyk
- Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland
| |
Collapse
|
8
|
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
|
9
|
|
10
|
Kawasaki K, Yamamoto K, Suzuki Y, Saito H. Surgery and radiation therapy for brain metastases from classic biphasic pulmonary blastoma. BMJ Case Rep 2014; 2014:bcr-2014-203990. [PMID: 24895392 DOI: 10.1136/bcr-2014-203990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pulmonary blastoma, a rare malignant lung tumour, can metastasise to the brain. However, there is no evidence for any effective treatment. The aim of this report is to discuss the treatment options for pulmonary blastoma and confirm the necessity for a pathological diagnosis. A 75-year-old man was admitted with progressive right-sided hemiplegia and aphasia. MRI showed multiple brain tumours. A left frontal lobe lesion was surgically resected, after which he underwent whole brain radiation (30 Gy/10 fractions). He died of an acute exacerbation of interstitial pneumonia. On performing autopsy, partial responses in the brain metastases that had been irradiated were confirmed pathologically. Thus, we present pathological confirmation that surgery and radiation therapy have therapeutic effects on brain metastases from pulmonary blastoma.
Collapse
Affiliation(s)
- Kenta Kawasaki
- Department of Internal Medicine, Keio University Hospital, Shinjuku-ku, Tokyo, Japan Department of Internal Medicine, Asahi General Hospital, Asahi, Japan
| | | | - Yoshio Suzuki
- Department of Pathology, Asahi General Hospital, Asahi, Japan
| | - Hirohisa Saito
- Department of Internal Medicine, Asahi General Hospital, Asahi, Japan
| |
Collapse
|
11
|
Giusti R, Iacono D, Ida P, Ruco L, Marchetti P. Multidisciplinary approach to fetal adenocarcinoma of the lung: A case report. Thorac Cancer 2014; 5:97-100. [PMID: 26766982 DOI: 10.1111/1759-7714.12022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 12/10/2012] [Indexed: 11/26/2022] Open
Abstract
This paper reports a case of high-grade fetal lung adenocarcinoma with particularly aggressive clinical and biological features in a 57-year-old man. Our patient first underwent neoadjuvant chemotherapy followed by surgery, and was then treated with adjuvant chemotherapy. Next, he had radiotherapy on the mediastinal region and prophylactic whole brain radiation therapy (WBRT). Following radiotherapy treatment, the patient started maintenance therapy with a somatostatin analogue. After 58 months of follow-up he is asymptomatic and disease free.
Collapse
Affiliation(s)
- Raffaele Giusti
- Medical Oncology, S. Andrea Hospital, Sapienza University II Faculty Rome, Italy
| | - Daniela Iacono
- Medical Oncology, S. Andrea Hospital, Sapienza University II Faculty Rome, Italy
| | - Paris Ida
- Medical Oncology, S. Andrea Hospital, Sapienza University II Faculty Rome, Italy
| | - Luigi Ruco
- Pathology, Department of Clinical and Molecular Medicine, S. Andrea Hospital, Sapienza University II Faculty Rome, Italy
| | - Paolo Marchetti
- Medical Oncology, S. Andrea Hospital, Sapienza University II Faculty Rome, Italy
| |
Collapse
|
12
|
Mao Z, Gu X, Sun J, Mao W, Zhu D, Shi T. [Pulmonary blastoma: long-term tracking report in a case with literature review]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2013; 16:387-90. [PMID: 23866672 PMCID: PMC6000660 DOI: 10.3779/j.issn.1009-3419.2013.07.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Zhiming Mao
- Department of Thoracic Surgery, Rugao Boai Hospital, Rugao 226500, China.
| | | | | | | | | | | |
Collapse
|
13
|
Mistry JH, Pawar SB, Mehta H, Popov AF, Mohite PN. Primary pulmonary blastoma of monophasic variety--diagnosis and management. J Cardiothorac Surg 2013; 8:144. [PMID: 23758909 PMCID: PMC3685585 DOI: 10.1186/1749-8090-8-144] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 06/06/2013] [Indexed: 12/13/2022] Open
Abstract
Pulmonary blastoma is a rare primary lung neoplasm, in that monophasic variety is far too rare. There are no specific clinical features seen for pulmonary blastoma; computed tomography and histopathology are diagnostic. Surgical excision is the treatment of choice; however, adjuvant chemotherapy and radiotherapy may be required in large and aggressive tumors.
Collapse
Affiliation(s)
- Jitendra H Mistry
- Department of Cardiothoracic Surgery, Medical College, Vadodara, Gujarat, India
| | | | | | | | | |
Collapse
|
14
|
Van Loo S, Boeykens E, Stappaerts I, Rutsaert R. Classic biphasic pulmonary blastoma: A case report and review of the literature. Lung Cancer 2011; 73:127-32. [DOI: 10.1016/j.lungcan.2011.03.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Revised: 03/08/2011] [Accepted: 03/23/2011] [Indexed: 10/18/2022]
|
15
|
Syrigos KN, Katirtzoglou N, Ntomi V, Pierrakou A, Chorti M, Stratakos G, Dannos I, Saif MW. Pulmonary blastoma with submandibular, scrotum and adrenal metastases: case report. ACTA ACUST UNITED AC 2011; 83:83-6. [PMID: 21447935 DOI: 10.1159/000324265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2011] [Indexed: 11/19/2022]
Abstract
A 62-year-old patient diagnosed with pulmonary blastoma with submandibular, scrotum and adrenal metastases was admitted to Sotiria General Hospital in Athens. No other such case has been published to date. The patient started receiving chemotherapy, but the scrotum metastasis grew rapidly and erupted. This led to sepsis despite surgical excision of infected and necrotic tissues and intravenous antibiotics. Treatment strategy in pulmonary blastoma should be defined by a multidisciplinary team, and surgical treatment should be considered as quickly as possible when such a tumor is suspected.
Collapse
Affiliation(s)
- Kostas N Syrigos
- Oncology Unit, 3rd Department of Medicine, Sotiria General Hospital, Athens University School of Medicine, Athens, Greece.
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Abstract
Pleuropulmonary blastoma is an extremely rare and aggressive thoracic tumour seen exclusively in children. The initial symptoms are respiratory and non specific and the chest X-ray done in that context reveals a thoracic mass. The chest CT scan then leads to the diagnosis of a cystic, mixt or solid mass. The diagnosis will be affirmed on anatomopathology of the tumour or biopsy. There are three different histological types: type I, cystic, type II, cystic and solid and type III, solid exclusively. Type I is less aggressive and its treatment is essentially surgical. Types II and III are highly aggressive and require surgery associated to polychemotherapy. In all cases, surgery is essential and should be the most complete possible. Extension and follow-up exams will include bone scan and brain imagery searching for metastasis as well as abdominal ultrasound searching associated renal lesions because 30% of pleuropulmonary blastoma are part of a familial predisposition syndrome.
Collapse
|
17
|
Preoperative radiation therapy and chemotherapy for pulmonary blastoma: a case report. J Thorac Oncol 2010; 5:282-3. [PMID: 20101153 DOI: 10.1097/jto.0b013e3181c420e1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
18
|
Kouvaris JR, Gogou PV, Papacharalampous XN, Kostara HJ, Balafouta MJ, Vlahos LJ. Solitary Brain Metastasis from Classic Biphasic Pulmonary Blastoma: A Case Report and Review of the Literature. Oncol Res Treat 2006; 29:568-70. [PMID: 17202827 DOI: 10.1159/000096708] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Classic biphasic pulmonary blastoma (CBPB) is a rare and aggressive primary malignancy, brain metastases of this type of tumor are even rarer. CASE REPORT A 51-year-old male patient with a solitary cerebral metastasis, diagnosed ten months after left pneumonectomy for a CBPB, was treated by surgery and accelerated hypofractionated radiotherapy. RESULTS The patient died 15 months after partial removal of the brain metastasis. Literature review revealed only 4 cases of solitary brain metastases from this type of malignancy. The present case is the second one reported with a combined treatment of surgery and radiotherapy resulting in the longest survival. CONCLUSION The best treatment for CBPB is difficult to determine because of the small number of cases, however, the combination of surgery with radiotherapy seems to be effective. The effectiveness of chemotherapy has not been ascertained.
Collapse
Affiliation(s)
- John R Kouvaris
- Departement of Radiation Oncology, Aretaieion Hospital, Medical School, University of Athens, Greece.
| | | | | | | | | | | |
Collapse
|
19
|
Pilla ES, Sanchez P, Mädke GR, Camargo S, Camargo JDJP. Blastoma pulmonar: tratamento cirúrgico por lobectomia superior direita e broncoplastia. J Bras Pneumol 2006; 32:75-7. [PMID: 17273572 DOI: 10.1590/s1806-37132006000100014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2005] [Accepted: 04/24/2005] [Indexed: 11/22/2022] Open
Abstract
O blastoma pulmonar é um tumor maligno raro, de crescimento rápido, composto por uma mistura de células epiteliais e mesenquimais malignas. Relatamos o caso de uma paciente com hemoptise e uma massa no lobo superior direito. Apresentava uma reserva pulmonar limitada e achado fibrobroncoscópico de comprometimento do brônquio intermediário. O tratamento realizado através de lobectomia superior direita com broncoplastia foi inédito. A paciente encontra-se assintomática após 36 meses de seguimento. A literatura é revisada em relação a aspectos clínicos, anatomopatológico e tratamento.
Collapse
|
20
|
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
|