title: [Biphasic pulmonary blastoma with germ cell differentiation: a challenge in diagnosis and treatment].
abstract: Serviço de Oncologia Médica. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal. A 27-year-old man, smoker, presented with three months history of fever. A left pulmonary mass inseparable from the heart was identified and serum alpha-fetoprotein was 4160 ng/ml. The morphologic aspects and immunohistochemistry of the biopsy specimen, in conjunction with the clinical findings were compatible with a diagnosis of pulmonary blastoma with germ cell differentiation. The tumour was considered unresectable. The patient was submitted to two cycles of primary chemotherapy with bleomycin, etoposide and cisplatin. Despite a reduction in serum alpha-fetoprotein, the tumor did not regress. Second line chemotherapy (with paclitaxel, ifosfamide and cisplatin) was instituted, but progressive disease was identified after 2 cycles. Six months after the diagnosis cerebral metastases were found and the patient died. This case illustrates a rare situation of difficult diagnosis and treatment.
authors.affiliation: Serviço de Oncologia Médica, Instituto Português de Oncologia Francisco Gentil, Porto, Portugal.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Teixeira
authors.forename: Claúdia
authors.initials: C
authors.lastname: Vieira
authors.forename: Nuno
authors.initials: N
authors.lastname: Sousa
authors.forename: Rosa
authors.initials: R
authors.lastname: Begonha
authors.forename: Mariana
authors.initials: M
authors.lastname: Afonso
authors.forename: Teresina
authors.initials: T
authors.lastname: Amaro
authors.forename: Joaquina
authors.initials: J
authors.lastname: Maurício
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001706:Biopsy; D001761:Bleomycin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D043823:Taxoids / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
chemical_list: D043823:Taxoids; D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide