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Liu Q, Li F, Wang L, Lv F, Yin Q, Liu G, Chen W. Pulmonary blastoma with a good prognosis: a case report and review of the literature. J Int Med Res 2024; 52:3000605241254778. [PMID: 38835107 PMCID: PMC11155335 DOI: 10.1177/03000605241254778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/26/2024] [Indexed: 06/06/2024] Open
Abstract
Pulmonary blastoma (PB) is a rare, highly malignant tumor prone to distant metastasis and recurrence, and the prognosis of these patients is often poor. We report a case of metastatic PB with a good prognosis with the aim of providing data to support a clinical diagnosis and treatment. In December 2015, a 43-year-old male patient was admitted to our hospital because of a cough and blood-stained sputum. Positron emission-computed tomography showed massive high-density imaging in the lower lobe of the right lung, with a maximum cross-section of 76 × 58 mm. Thoracoscopic-assisted right lower lobectomy with lymph node dissection was performed. After 1 month, computed tomography showed a high possibility of metastasis. The patient then received docetaxel and cisplatin chemotherapy for a total of six courses. After chemotherapy, enhanced computed tomography showed considerable absorption of pleural effusion, and a left lobe pulmonary nodule was not detected. The postoperative pathological diagnosis was PB, and epithelial and mesenchymal differentiation components were observed. The patient continued to visit the hospital regularly for re-examination and imaging examinations. Currently, no signs of recurrence or distant metastasis have been detected.
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Affiliation(s)
- Qingru Liu
- Department of Pathology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Fengchao Li
- Department of Pathology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Lulu Wang
- Department of Pathology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Feng Lv
- Department of Pathology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Qianqian Yin
- Department of Pathology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Guangzhen Liu
- Department of Pathology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wen Chen
- Department of Pathology, The 8th Medical Center, Chinese PLA General Hospital, Beijing, China
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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.
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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.
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Zhuo Y, Xu Y, Qin R, Guo M, Zhang D. High-grade fetal adenocarcinoma of the lung misdiagnosed as male breast carcinoma: a case report and literature review. Front Oncol 2023; 13:1293534. [PMID: 38125938 PMCID: PMC10730678 DOI: 10.3389/fonc.2023.1293534] [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: 09/13/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
Background and aim High-grade fetal adenocarcinoma of the lung (HG-FLAC) is a specific subtype of lung adenocarcinoma with a poor prognosis. A lack of understanding exists because of the rarity of this disease. This study aimed to present a case of HG-FLAC with multiple metastases misdiagnosed as male breast carcinoma at the initial diagnosis. Case presentation The patient visited our hospital due to a month-long cough. The chest computed tomography (CT) scan revealed a mass in the left lung and chest wall, accompanied by enlargement of mediastinal lymph nodes. The magnetic resonance imaging indicated potential metastatic lesions in the brain and adrenal glands. The patient underwent a biopsy of the lesion in the right chest wall. The pathological and immunohistochemical findings indicated a high possibility of male breast cancer. However, the clinical features did not support this diagnosis. Therefore, a CT-guided percutaneous lung biopsy was performed, and the pathological examination finally indicated HG-FLAC. Conclusions We presented a complex yet interesting case in which HG-FLAC was misdiagnosed as male breast cancer. Our interesting case may stimulate discussions about the methods to manage patients with HG-FLAC.
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Affiliation(s)
- Yuejian Zhuo
- Department of Oncology, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Yanran Xu
- Department of Pathology, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Rong Qin
- Department of Pathology, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Min Guo
- Department of Pathology, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Dongdong Zhang
- Department of Oncology, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
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Yao H, Jiang X, Zeng Y, Wang X, Tang X. Classic biphasic pulmonary blastoma: A case report and review of the literature from 2000 to 2022. THE CLINICAL RESPIRATORY JOURNAL 2023; 17:1103-1116. [PMID: 37772674 PMCID: PMC10632085 DOI: 10.1111/crj.13701] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/23/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023]
Abstract
Classic biphasic pulmonary blastoma (CBPB), a distinct type of lung cancer, is a dual-phasic tumor characterized by the co-existence of low-grade fetal adenocarcinoma and primitive mesenchymal stroma. Accounting for less than 0.1% of surgically removed lung cancers, CBPB commonly presents in individuals during their fourth to fifth decades of life, with smoking as a significant risk factor. The optimal management strategy entails surgical resection, supplemented by chemotherapy to improve prognosis. The frontline chemotherapeutic agents typically include platinum agents and etoposide, with preoperative neoadjuvant chemotherapy potentially enabling operability for initially inoperable cases. In recent years, targeted therapies, such as antiangiogenic agents, have emerged as promising new treatment strategies for CBPB. For patients exhibiting brain metastases or deemed inoperable, radiation therapy proves to be a crucial therapeutic component. CBPB prognosis is adversely affected by factors such as early metastasis, tumor size exceeding 5 cm, and tumor recurrence. In this regard, serological markers have been identified as valuable prognostic indicators. To exemplify, we recount the case of a 44-year-old female patient with CBPB, wherein serum lactate dehydrogenase levels showed significant diagnostic value. This report further incorporates a comprehensive review of CBPB literature from the past 22 years.
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Affiliation(s)
- Hui Yao
- Department of PathologyChongqing General HospitalChongqingChina
| | - Xin Jiang
- Department of PathologyChongqing General HospitalChongqingChina
| | - Ying Zeng
- Department of PathologyChongqing General HospitalChongqingChina
| | - Xue Wang
- Department of PathologyChongqing General HospitalChongqingChina
| | - Xuefeng Tang
- Department of PathologyChongqing General HospitalChongqingChina
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Jiang J, Ren Y, Xu C, Lin X. NUT midline carcinoma as a primary lung tumor treated with anlotinib combined with palliative radiotherapy: a case report. Diagn Pathol 2022; 17:4. [PMID: 34996489 PMCID: PMC8742416 DOI: 10.1186/s13000-021-01188-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 12/03/2021] [Indexed: 01/12/2023] Open
Abstract
Background NUT (nuclear protein in testis) midline carcinoma (NMC) is a rapidly progressive tumor arising from midline structures. Recent cases have reported that the poor prognosis with a median survival of 6.7 months and a 2 years overall survival of 19% due to limited treatment. Based on the effect of arotinib on inhibiting tumor growth and angiogenesis. We present one patient case treated with anlotinib and radiotherapy. Case presentation Here, we describe a 33-year old patient who complained of cough and chest pain and was diagnosed as a pulmonary NMC through CT scan, FISH and immunohistochemistry. In addition, we initially demonstrated that anlotinib combined with palliative radiotherapy could significantly prevent the tumor growth in a pulmonary NMC. Conclusion The report indicated that anlotinib combined with palliative radiotherapy could inhibit the tumor progression in a pulmonary NMC, which may provide a combined therapy to pulmonary NMC in the future.
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Affiliation(s)
- Jin Jiang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yikun Ren
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Chengping Xu
- Department of Pathology, The Southwest Hospital, the Southwest Hospital of Army Medical University, Chongqing, 400038, China
| | - Xing Lin
- Department of Biological Immunotherapy, Chongqing University Cancer Hospital, Chongqing Cancer Institute, Chongqing Cancer Hospital, Shapingba District, Chongqing, 400030, China.
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Budzik MP, Panek G, Bińkowska M, Osuch B, Borkowska E, Badowska-Kozakiewicz AM. Pulmonary blastoma in a pregnant woman: a case report and brief review of the literature. BMC Pulm Med 2022; 22:8. [PMID: 34983474 PMCID: PMC8724745 DOI: 10.1186/s12890-021-01804-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 12/18/2021] [Indexed: 11/10/2022] Open
Abstract
Background Pulmonary blastoma (PB) comprises a rare heterogeneous group of lung tumours typically containing immature epithelial and mesenchymal structures that imitate the embryonic lung tissue and extremely rarely occurs during pregnancy. Although cough and haemoptysis are the most common PB symptoms, they usually indicate other serious pregnancy-related complications. Case presentation The article presents the unusual case of a 22-year-old pregnant woman diagnosed with PB during pregnancy. Conclusions PB is characterized by poor prognosis and patients’ outcome relies on a rapid diagnosis. Surgery remains the most common and effective treatment. Due to the extreme rarity, the literature contains only single mentions of PB in pregnancy, thus its impact on the course of pregnancy and the developing fetus remains unknown.
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Affiliation(s)
- Michał P Budzik
- Department of Gynaecologic Oncology and Obstetrics, Centre of Postgraduate Medical Education, 231 Czerniakowska, 00-416, Warsaw, Poland. .,Department of Cancer Prevention, Medical University of Warsaw, 81 Żwirki i Wigury, 02-091, Warsaw, Poland.
| | - Grzegorz Panek
- Department of Gynaecologic Oncology and Obstetrics, Centre of Postgraduate Medical Education, 231 Czerniakowska, 00-416, Warsaw, Poland
| | - Małgorzata Bińkowska
- Department of Gynaecologic Oncology and Obstetrics, Centre of Postgraduate Medical Education, 231 Czerniakowska, 00-416, Warsaw, Poland
| | - Beata Osuch
- Department of Gynaecologic Oncology and Obstetrics, Centre of Postgraduate Medical Education, 231 Czerniakowska, 00-416, Warsaw, Poland
| | - Ewa Borkowska
- Student Scientific Association, Medical University of Warsaw, 1 Oczki, 02-001, Warsaw, Poland
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Pooniya S, McKinnie A, Taylor T, Will M, Wallace W. Classic biphasic pulmonary blastoma (CBPB): a rare primary pulmonary malignancy. BMJ Case Rep 2021; 14:e244151. [PMID: 34376421 PMCID: PMC8356168 DOI: 10.1136/bcr-2021-244151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 11/04/2022] Open
Abstract
Classic biphasic pulmonary blastoma (CBPB) is a very rare primary pulmonary malignancy with distinctive clinical and pathological features. Usually CBPB presents with either non specific symptoms or is diagnosed incidentally. Histologically CBPB is composed of a mixture of malignant epithelial and stromal cells resembling fetal lung tissue. Surgical resection is the mainstay of treatment with further chemotherapy or radiotherapy on a case-by-case basis. However, due to its rarity, no definite treatment guidelines are available. CBPB overall has a very poor prognosis with a 5-year survival rate of only 15%. Our patient presented with cough and haemoptysis. Her chest radiograph demonstrated a large right-sided lung mass. Further investigations included CT, CT-guided biopsy and PET CT which were discussed at multidisciplinary team meetings. The patient then underwent complete surgical excision. We report this rare malignancy with radiological and pathological features, comparing them with previously reported cases.
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Affiliation(s)
- Shashank Pooniya
- Clinical Radiology, Ninewells Hospital and Medical School, Dundee, UK
| | - Angela McKinnie
- Clinical Radiology, Ninewells Hospital and Medical School, Dundee, UK
| | - Thomas Taylor
- Clinical Radiology, Ninewells Hospital and Medical School, Dundee, UK
| | - Malcolm Will
- Consultant Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - William Wallace
- Professor Pathology, Royal Infirmary of Edinburgh, Edinburgh, UK
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