Pulmonary blastoma--a rare tumor with variable presentation.
BACKGROUND
Pulmonary blastoma is a rare primary lung tumor with poor prognosis that commonly presents at a younger age than the non-small cell lung carcinoma (NSCLC). Classically they are large, symptomatic tumors with lymph nodal metastasis and carry poor prognosis. We report our experience of 7 patients with pulmonary blastoma who presented with varying clinical features.


METHODS
Retrospective analysis of our database revealed seven patients with pulmonary blastoma that were operated between January 1993 and December 2004. During the same time, 889 lung resections were performed for primary NSCLC. Demographic and clinical details were obtained from hospital notes. The histopathology reports were reviewed with the department of pathology and the radiological images were reported.


RESULTS
The tumors showed a bimodal pattern in age at incidence being (four patients were less than 49 years and three more than 66 years). All patients were symptomatic and demonstrated variable sized tumors. Lesions were common in lower lobes (lower:other lobes -4:3) and were staged T2N0 pathologically. All of the patients underwent surgical resections and had no chemotherapy/radiotherapy following surgery. Three of the seven patients died during follow-up due to unrelated causes between 24 and 29 months. The longest follow-up was more than 9 years and the survivor continues to do well.


CONCLUSIONS
Pulmonary blastomas are rare tumors but can present with differing clinical features. Early detection and treatment may improve prognosis. Further larger series are needed to evaluate the characteristics of the tumor.
Adluri
Rajeshwara Krishna Prasad
RK
Department of Thoracic Surgery, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, United Kingdom. arkrishnap@yahoo.com
Boddu
Srikanth Reddy
SR
Martin-Ucar
Antonio
A
Duffy
John Peter
JP
Beggs
Frederick David
FD
Morgan
William Ellis
WE
D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018202:Pulmonary Blastoma / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D017678:Sex Distribution; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome