Classic biphasic pulmonary blastoma: A case report and review of the literature from 2000 to 2022

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.

18F-FDG PET/CT images of adult pulmonary blastoma: a case report

“…About 40 % of cases remain asymptomatic and are revealed during incidental chest X-ray or CT. Laboratory examination results are often non-specific, some reports presented elevated serum levels of AFP, CEA, and LDH [1,6]. Surgery is the main treatment option for PB with or without neoadjuvant chemotherapy.…”

“…Isolated cases of long-term survival are reported [8]. PB prognosis depends predominantly on the tumor size exceeding 5 cm, tumor relapse, and metastasis [6]. Metastasis mainly occur in the brain, pleura, mediastinum, diaphragm, liver, pancreas, kidneys, adrenals, scrotum and ovaries [9,10].…”