Pulmonary blastoma: A rare pulmonary tumor
We report the observation of a 5-year-old child who showed up for a rapid worsening dyspnea associated with a dry cough. The clinical examination found a patient in poor general condition with a pleural effusion syndrome fluid right. Chest X-ray revealed a compressive opacity occupying almost all of the right pulmonary field. Biology showed hypoxia at 55 mmHg. The CT examination demonstrated an expansive process of paraliquidienne density occupying the lower 2/3 of the right Hemithorax associated with a right pleurisy of great abundance. The pleural puncture reduced 400 ml of hemorrhagic fluid containing no malignant cells to the cytological examination.
Given the severity of the patient's condition and the inability to confirm the diagnosis, the patient was operated in a dual purpose, curative and causative. The peroperative exploration revealed a ruptured polylobée tumor in the pleural cavity, of cystic allure developing at the junction of the lower and middle lobes. The gesture consisted of a lower and medium bilobectomy with ganglionic clearing and resection of the parietal pleura. The diagnosis of pulmonary blastoma was confirmed by the Anatomopathologic study of the operative part. Chemotherapy was indicated in addition to the surgery. The patient is currently in remission after an 18-month retreat.
Pulmonary blastoma is a rare primitive pulmonary neoplasia representing less than 0.5% of primary lung cancers. It is composed of an immature mesenchymal tissue and a primitive epithelial tissue that resembles the fetal lung tissue. It has a rapid evolutionary potential and a pejorative prognosis.
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