RESUMO
Pleuropulmonary blastoma is an uncommon paediatric neoplasm. Approximately 300 cases have been reported. In seven tumours, extension involved the left heart. Type III occurs typically at ages 3 or 4 years. We report this very unusual case of extensive disease in a 16-month old male patient. Chest computerized tomography revealed a mass extending into the right hemithorax from the posterior mediastinum and propagating inside the left atrium through the right pulmonary veins. Echocardiography showed a huge flexible mass occupying almost all of the left atrium cavity and intermittently prolapsing through the mitral valve. Two preoperative chemotherapy courses of ifosfamide, vincristine, actinomycin D and doxorubicin were administered at 3-week intervals. The patient was placed on cardiopulmonary bypass, cardiac arrest and the left atrium was opened. The tumour and orifice of the inferior right pulmonary vein were resected and the normal free borders reconstructed. A large mass occupying the right pleural space was removed. Seven additional courses of chemotherapy were given. In a 'second-look' surgery 6 months later, through a right thoracotomy, the residual mass at the posterior mediastinum was resected. The child received four additional courses of chemotherapy. After 12 months of the initial resection, there is no evidence of recurrence.
Assuntos
Átrios do Coração , Neoplasias Cardíacas , Neoplasias Pulmonares , Blastoma Pulmonar , Antineoplásicos/uso terapêutico , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Átrios do Coração/cirurgia , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/tratamento farmacológico , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Humanos , Lactente , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Blastoma Pulmonar/diagnóstico , Blastoma Pulmonar/tratamento farmacológico , Blastoma Pulmonar/patologia , Blastoma Pulmonar/cirurgia , RadiografiaAssuntos
Neoplasias Pulmonares/patologia , Blastoma Pulmonar/patologia , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Dor no Peito/etiologia , Cisplatino/administração & dosagem , Etoposídeo/administração & dosagem , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Blastoma Pulmonar/complicações , Blastoma Pulmonar/tratamento farmacológico , Radiografia TorácicaRESUMO
Se presentan 3 casos de tumores primitivos de origen pleuropulmonar:2 blastomas pleuropulmonares y un mesotelioma.Se obtuvieron inicialmente remisiones completas con quimioterapia convencional,cirugía y en uncaso se agregó radioterapia.Un paciente murió a los 14 meses y 2 están en progresión de enfermedad 12 y 14 meses después del diagnóstico.Terapia multimodal,cirugía,poliquimioterapia y radioterapia,juegan un rol importante en el tratamiento de estos tumores,sin embargo es insuficiente y no previenen la recurrencia local y/o metástasis.Se hace hincapié en el mal pronóstico de este tipo de tumores
Assuntos
Humanos , Pré-Escolar , Blastoma Pulmonar/cirurgia , Blastoma Pulmonar/diagnóstico , Mesotelioma/cirurgia , Mesotelioma/diagnóstico , Blastoma Pulmonar/tratamento farmacológico , Blastoma Pulmonar/radioterapia , Mesotelioma/tratamento farmacológico , Mesotelioma/radioterapiaRESUMO
Se presentan 3 casos de tumores primitivos de origen pleuropulmonar:2 blastomas pleuropulmonares y un mesotelioma.Se obtuvieron inicialmente remisiones completas con quimioterapia convencional,cirugía y en uncaso se agregó radioterapia.Un paciente murió a los 14 meses y 2 están en progresión de enfermedad 12 y 14 meses después del diagnóstico.Terapia multimodal,cirugía,poliquimioterapia y radioterapia,juegan un rol importante en el tratamiento de estos tumores,sin embargo es insuficiente y no previenen la recurrencia local y/o metástasis.Se hace hincapié en el mal pronóstico de este tipo de tumores
Assuntos
Humanos , Pré-Escolar , Mesotelioma/diagnóstico , Mesotelioma/cirurgia , Blastoma Pulmonar/diagnóstico , Blastoma Pulmonar/cirurgia , Mesotelioma/tratamento farmacológico , Mesotelioma/radioterapia , Blastoma Pulmonar/tratamento farmacológico , Blastoma Pulmonar/radioterapiaRESUMO
Se presenta el caso de un paciente de 18 anos de edad, de raza blanca y sexo masculino, con manifestaciones respiratorias de tos, expectoracion, dolor toracico y rayos X de torax con una masa del lobulo superior izquierdo. Despues de pleurotomia minima y biopsia se le diagnostico un blastoma pulmonar. Se le realizo neumectomia y posteriormente, se le administro poliquimioterapia
Assuntos
Humanos , Masculino , Adolescente , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/cirurgia , Pneumonectomia/métodos , Blastoma Pulmonar/tratamento farmacológico , Blastoma Pulmonar/cirurgiaRESUMO
Pulmonary blastoma (PB) is a rare primary malignancy of the lung, with about 54 cases reported in children. The tumor consists of mesenchymal and epithelial components resembling the fetal lung. It has been treated primarily with surgery and the effect of combination chemotherapy has not been systematically investigated. A 15-year-old girl with PB with metastases to bone and regional lymph node, and high levels of alphafetoprotein, is reported. A preoperative combination chemotherapy consisting of cisplatinum, etoposide alternating with iphosphamide with mesna, vincristine and epirubicine resulted in an objective response that permitted subsequent safe surgical excision of the primary tumor. This intensive combination chemotherapy should be tested in the management of advanced PB in children, as initial therapy as well as an adjuvant to surgery.