Type III pleuropulmonary blastoma in a dicer1 germline mutation carrier: The management of residual lung cystic lesions

Pediatr Blood Cancer. 2017 Aug;64(8). doi: 10.1002/pbc.26438. Epub 2017 Jan 18.

Abstract

Pleuropulmonary blastoma (PPB) is a rare malignancy of childhood. It often represents a manifestation of a hereditary tumor predisposition syndrome (DICER1 syndrome). Because of its malignant potential, surgical resection of cystic lung lesions is recommended in germline DICER1 mutation carriers. We present a case of a 3-year-old male child with type III PPB successfully managed with ifosfamide, vincristine, actinomycin-D, and doxorubicin (IVADo) chemotherapy and surgery. A heterozygous germline pR688X mutation of DICER1 gene was demonstrated. Six years after primary diagnosis, several small lung cysts remained stable without further therapy. The management of residual asymptomatic lung cysts represents a clinical challenge in these patients.

Keywords: DICER1; pleuropulmonary blastoma; pulmonary cysts.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Child, Preschool
  • Cysts / pathology
  • DEAD-box RNA Helicases / genetics*
  • Dactinomycin / administration & dosage
  • Doxorubicin / administration & dosage
  • Germ-Line Mutation
  • Heterozygote
  • Humans
  • Ifosfamide / administration & dosage
  • Lung Diseases / pathology
  • Male
  • Pulmonary Blastoma / drug therapy
  • Pulmonary Blastoma / genetics*
  • Pulmonary Blastoma / pathology
  • Ribonuclease III / genetics*
  • Vincristine / administration & dosage

Substances

  • Dactinomycin
  • Vincristine
  • Doxorubicin
  • DICER1 protein, human
  • Ribonuclease III
  • DEAD-box RNA Helicases
  • Ifosfamide

Supplementary concepts

  • Pleuropulmonary blastoma