title: Pulmonary blastoma after liver transplant: a case report.
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.
authors.affiliation: Department of Medical Oncology, Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture (PZ), Italy. tarta1@virgilio.it
authors.forename: Alfredo
authors.initials: A
authors.lastname: Tartarone
authors.forename: Giampiero
authors.initials: G
authors.lastname: Romano
authors.forename: Rocco
authors.initials: R
authors.lastname: Galasso
authors.forename: Mariarosa
authors.initials: M
authors.lastname: Coccaro
authors.forename: Aldo
authors.initials: A
authors.lastname: Cammarota
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sgambato
authors.forename: Annamaria
authors.initials: A
authors.lastname: Bochicchio
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000628:therapy*; D016031:Liver Transplantation; D008175:Lung Neoplasms / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018202:Pulmonary Blastoma / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D012307:Risk Factors; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077235:Vinorelbine
chemical_list: D007166:Immunosuppressive Agents; D014747:Vinblastine; D005047:Etoposide; D002945:Cisplatin; D000077235:Vinorelbine; D007069:Ifosfamide