Pulmonary blastoma: medium-term results from a regional center

doi:10.1016/S0003-4975(02)03494-X

The Annals of Thoracic Surgery

Volume 73, Issue 5, May 2002, Pages 1572-1575

https://doi.org/10.1016/S0003-4975(02)03494-X Get rights and content

Abstract

Background. Pulmonary blastomas are rare lung tumors that morphologically resemble fetal pulmonary structure and can exist in two forms, biphasic and monophasic. We reviewed our experience over a 12-year period with emphasis on the clinical features, management, and outcome.

Methods. Patients with a diagnosis of pulmonary blastoma from January 1988 to July 1999 were identified from the database of the Department of Histopathology, Llandough Hospital, Cardiff. Specimens had been obtained from bronchoscopy, fine-needle aspiration, trucut biopsy, and thoracotomy.

Results. Six patients were identified from 2,720 histologically proven lung cancers (0.2%). Median age was 35.5 years and sex ratio was equal. Overall, 4 patients underwent resection and are all alive (median, 43.5 months). Three of these had advanced tumors at presentation (stage IIIb or IV), two of which were successfully downstaged with neoadjuvant chemotherapy, and the third treated with postoperative radiotherapy. Nonresected cases succumbed at a median of 5.5 months.

Conclusions. Although pulmonary blastomas are rare, those affected represent a group of patients with advanced tumors for whom a coordinated approach from both oncologists and surgeons can achieve excellent medium-term results.

Section snippets

Material and methods

Patients with a diagnosis of pulmonary blastoma from January 1988 to July 1999 were identified from the database of the Department of Histopathology, Llandough Hospital, Cardiff. Specimens had been obtained from bronchoscopy, fine-needle aspiration, trucut biopsy, and thoracotomy. Histopathologic diagnosis was confirmed by two experienced pathologists specializing in pulmonary histopathology. Biphasic pulmonary blastomas were defined as those tumors containing malignant mesenchyme and

Results

Six patients with pulmonary blastoma were identified from this period. Two thousand seven hundred twenty lung cancers were diagnosed in the histopathology department during this same period, giving an incidence of 0.2% for all histologically verified lung cancers. Histologic features, stage, treatment, and outcome are summarized in Table 1.

The median age at presentation was 35.5 years, with equal sex incidence. Five tumors occurred in smokers (mean consumption, 14.8 pack years), and

Comment

Pulmonary blastomas are rare, and much of the world literature derives from reviews of isolated case reports [11] or the experience of multiple centers during several decades [1]. Therefore, we sought to review our experience with this tumor in a single teaching hospital (with a large referral base) during a 10-year period. Before 1988 pleuropulmonary blastoma of childhood was also included in this group by some authorities, leading to discrepancies between investigators in the perceived

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Original article: general thoracicPulmonary blastoma: medium-term results from a regional center

Abstract

Section snippets

Material and methods

Results

Comment

Chest

Cancer Treatment Rev

Pulmonary blastomas

Cancer

Embryoma of the lung

Thorax

Pulmonary blastomas

J Pathol Bacteriol

Pleuropulmonary blastoma. The so-called pulmonary blastoma of childhood

Cancer

Original article: general thoracic
Pulmonary blastoma: medium-term results from a regional center