A rare presentation of biphasic pulmonary blastoma

Department of Pathology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil.
Archives of pathology & laboratory medicine (Impact Factor: 2.84). 08/2002; 126(7):875-6. DOI: 10.1043/0003-9985(2002)126<0875:ARPOBP>2.0.CO;2
Source: PubMed
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    ABSTRACT: The 2004 World Health Organization (WHO) classification of lung tumors1 defines sarcomatoid carcinomas as a group of poorly differentiated, non-small-cell lung carcinomas that contain a component of sarcoma or sarcomalike (spindle or giant cell) differentiation. Five subgroups are currently recognized: pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma, and pulmonary blastoma. These entities have been considered separately previously. The WHO does not recommend the use of the terms homologous or heterologous, as proposed by Wick et al.2 These tumors are rare, accounting for approximately between 0.3% and 1.3% of all lung malignancies.1
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    ABSTRACT: Pulmonary blastomas are rare malignant tumors, comprising only 0.25-0.5% of all malignant lung neoplasms. Pulmonary blastomas are subdivided in three categories: well-differentiated fetal adenocarcinoma (WDFA), classic biphasic pulmonary blastoma (CBPB) and pleuropulmonary blastoma (PPB), which is currently regarded as a separate entity. The majority of patients with CBPB and WDFA are adults with an average age of 43 years. Tobacco use is identified as a causative agent. Symptomatology varies from asymptomatic (40%) to symptoms of a non-specific pulmonary disease. The most common roentgenologic pattern is a large peripheral nodule. The treatment of choice is surgical excision. The efficacy of adjuvant chemotherapy and radiotherapy is not yet established. The prognosis of pulmonary blastoma is very poor; overall five-year survival is 16%. WDFA appears to have a better prognosis. Adverse prognostic factors are biphasic type, tumor recurrence, metastasis at initial presentation, gross size of the tumor (>5 cm) and lymph node metastasis. On the basis of the available literature, an initial aggressive treatment that includes surgery and, wherever possible, postoperative chemotherapy and radiotherapy could be useful to prolong survival in patients with this rare lung neoplasm. We present a case of classic biphasic pulmonary blastoma in a 77-year old male and review the literature.
    No preview · Article · Apr 2011 · Lung cancer (Amsterdam, Netherlands)