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Bronchioloalveolar carcinoma in a juvenile rhadomyosarcoma patient.

Choi SH, Jeon HW, Oh WJ, Park JK - Korean J Thorac Cardiovasc Surg (2014)

Bottom Line: Comprehensive evaluation disclosed numerous pulmonary metastases of rhabdomyosarcoma (stage IV).During chemotherapy, most of the lung lesions regressed, with the exception of two nodules.Wedge resections, intended for diagnosis and cure, yielded a histologic diagnosis of BAC.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Korea.

ABSTRACT
Primary tumors of the lung are uncommon in pediatric patients, particularly bronchioloalveolar carcinoma (BAC). An 11-year-old female suffering from back pain for 1 month was referred to Seoul St. Mary's Hospital for treatment of a pathologic fracture of the lumbar spine. Comprehensive evaluation disclosed numerous pulmonary metastases of rhabdomyosarcoma (stage IV). During chemotherapy, most of the lung lesions regressed, with the exception of two nodules. Wedge resections, intended for diagnosis and cure, yielded a histologic diagnosis of BAC.

No MeSH data available.


Related in: MedlinePlus

Initial chest X-ray. (A) Posterioranterior (PA) view: pleural effusion and lower lobe infiltrate on left. (B) Left lateral view: left pleural effusion with thickened fissure, indicative of pleural lesion.
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Figure 1: Initial chest X-ray. (A) Posterioranterior (PA) view: pleural effusion and lower lobe infiltrate on left. (B) Left lateral view: left pleural effusion with thickened fissure, indicative of pleural lesion.

Mentions: An 11-year-old female was referred to our care for the treatment of a pathologic fracture of the lumbar spine. One month prior, she had fallen during exercise, causing persistent back pain. When symptoms failed to abate, computed tomography (CT) of the spine was performed, revealing a fracture at the L-2 level that was most likely pathologic. Given the circumstances, she was admitted to Seoul St. Mary's Hospital as a pediatric hematology patient. A chest X-ray (Fig. 1) revealed a left lower lobe infiltrate with pleural effusion, and the chest CT revealed bilateral pleural effusions with multiple, diffuse nodules of both lungs. Positron emission tomography (PET)-CT further disclosed whole-body tumor involvement. Biopsies of the bone marrow and the sole of the right foot confirmed stage IV rhabdomyosarcoma. After 5 months of chemotherapy, a complete metabolic response was evident by PET-CT; and after 11 months of treatment, the lung lesions and pleural effusions had essentially resolved. However, two nodules persisted in the left lung-one in the upper lobe and the other in the superior segment of the lower lobe (Fig. 2B). For diagnostic and curative purposes, wedge resection of these two nodules was performed via mini-thoracotomy. The patient's recovery was uneventful, and she was discharged on postoperative day 6.


Bronchioloalveolar carcinoma in a juvenile rhadomyosarcoma patient.

Choi SH, Jeon HW, Oh WJ, Park JK - Korean J Thorac Cardiovasc Surg (2014)

Initial chest X-ray. (A) Posterioranterior (PA) view: pleural effusion and lower lobe infiltrate on left. (B) Left lateral view: left pleural effusion with thickened fissure, indicative of pleural lesion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928265&req=5

Figure 1: Initial chest X-ray. (A) Posterioranterior (PA) view: pleural effusion and lower lobe infiltrate on left. (B) Left lateral view: left pleural effusion with thickened fissure, indicative of pleural lesion.
Mentions: An 11-year-old female was referred to our care for the treatment of a pathologic fracture of the lumbar spine. One month prior, she had fallen during exercise, causing persistent back pain. When symptoms failed to abate, computed tomography (CT) of the spine was performed, revealing a fracture at the L-2 level that was most likely pathologic. Given the circumstances, she was admitted to Seoul St. Mary's Hospital as a pediatric hematology patient. A chest X-ray (Fig. 1) revealed a left lower lobe infiltrate with pleural effusion, and the chest CT revealed bilateral pleural effusions with multiple, diffuse nodules of both lungs. Positron emission tomography (PET)-CT further disclosed whole-body tumor involvement. Biopsies of the bone marrow and the sole of the right foot confirmed stage IV rhabdomyosarcoma. After 5 months of chemotherapy, a complete metabolic response was evident by PET-CT; and after 11 months of treatment, the lung lesions and pleural effusions had essentially resolved. However, two nodules persisted in the left lung-one in the upper lobe and the other in the superior segment of the lower lobe (Fig. 2B). For diagnostic and curative purposes, wedge resection of these two nodules was performed via mini-thoracotomy. The patient's recovery was uneventful, and she was discharged on postoperative day 6.

Bottom Line: Comprehensive evaluation disclosed numerous pulmonary metastases of rhabdomyosarcoma (stage IV).During chemotherapy, most of the lung lesions regressed, with the exception of two nodules.Wedge resections, intended for diagnosis and cure, yielded a histologic diagnosis of BAC.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Korea.

ABSTRACT
Primary tumors of the lung are uncommon in pediatric patients, particularly bronchioloalveolar carcinoma (BAC). An 11-year-old female suffering from back pain for 1 month was referred to Seoul St. Mary's Hospital for treatment of a pathologic fracture of the lumbar spine. Comprehensive evaluation disclosed numerous pulmonary metastases of rhabdomyosarcoma (stage IV). During chemotherapy, most of the lung lesions regressed, with the exception of two nodules. Wedge resections, intended for diagnosis and cure, yielded a histologic diagnosis of BAC.

No MeSH data available.


Related in: MedlinePlus