Abstract
Introduction Pleuropulmonary blastoma (PPB) is an aggressive primary
neoplasm of pleuropulmonary mesenchyme occurring in children. Given its
rarity, the International Pleuropulmonary Blastoma Registry (IPPBR) was
established in 1988 to collect and assess data on PPB worldwide. We
assessed the clinical characteristics, histopathology, genetic studies,
management, and treatment outcomes of patients with PPB in our
institution, and compared with the published literature. Materials and
Methods We retrospectively reviewed the medical records of all PPB cases
diagnosed at Princess Margaret Hospital for Children in Western
Australia over a period of 26 years (1990-2016). Results Seven children
(4 boys and 3 girls) were treated for PPB at a mean age of 11.5 months
(ranges 1 month to 3.55 years). Histopathology showed type I PPB in
five, type II in one, and type III in one. All seven patients underwent
thoracotomy/lobectomy of the corresponding site. One patient required
additional bladder resection for coexisting rhabdomyosarcoma. One
patient was found to be positive for DICER1 gene mutation. Six patients
received adjuvant chemotherapy with vincristine, adriamycin,
cyclophosphamide (VAC) regime, with the mean duration of treatment for
five patients being 9.4 months excluding one patient who deceased
without completion of chemotherapy. During a mean follow-up time of 9
years, the overall survival rate for this cohort was 85.7% (6/7).
Conclusions Our results are similar to those reported in the literature.
It is crucial for clinicians to consider PPB in the evaluation of
patients presenting with a cystic lung abnormality, especially in cases
with DICER1 mutation or a strong family history of unusual cancers.