Vipin Zamvar

Pulmonary blastoma: medium-term results from a regional center

BACKGROUND Pulmonary blastomas are rare lung tumors that morphologically resemble fetal pulmonary structure and can exist in two forms, biphasic and monophasic. We reviewed our experience over a 12-year period with emphasis on the clinical features, management, and outcome. METHODS Patients with a diagnosis of pulmonary blastoma from January 1988 to July 1999 were identified from the database of the Department of Histopathology, Llandough Hospital, Cardiff. Specimens had been obtained from bronchoscopy, fine-needle aspiration, trucut biopsy, and thoracotomy. RESULTS Six patients were identified from 2,720 histologically proven lung cancers (0.2%). Median age was 35.5 years and sex ratio was equal. Overall, 4 patients underwent resection and are all alive (median, 43.5 months). Three of these had advanced tumors at presentation (stage IIIb or IV), two of which were successfully downstaged with neoadjuvant chemotherapy, and the third treated with postoperative radiotherapy. Nonresected cases succumbed at a median of 5.5 months. CONCLUSIONS Although pulmonary blastomas are rare, those affected represent a group of patients with advanced tumors for whom a coordinated approach from both oncologists and surgeons can achieve excellent medium-term results.

Juxtacardiac costal osteochondroma presenting as recurrent haemothorax

A 21-year-old man presenting with a recurrent spontaneous haemothorax was found to have an osteochondroma arising out of the left 4th rib. This was penetrating the apical part of the heart. Surgical excision was uneventful.

Extraskeletal Ewing's sarcoma presenting as a mediastinal mass.

Ewings sarcoma family of tumors is part of a rare group of malignant neoplasms with small blue, round-cell morphology on hematoxylin and eosin stain, expressing CD99, C-Kit, and Bcl2, and sharing the presence of the translocation t(11:22). Extraskeletal Ewings sarcoma is a rare disease that typically involves the soft tissues of the trunk or extremities. We describe a case of extraskeletal Ewings sarcoma presenting as a mediastinal mass in a 16-year-old boy.