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An unusual case of pleuropulmonary blastoma in a child with jejunal hamartomas
Chantal Lucia-Casadonte1, Sakil Kulkarni, Ricardo Restrepo
1Department of Medical Education, Miami Children's Hospital, Miami, FL 33155, USA.
Insights
This case report details a rare association between pleuropulmonary blastoma (PPB) and a jejunal hamartoma in an infant. Early screening for associated conditions is crucial for pediatric patients diagnosed with PPB.
Area of Science:
- Pediatric Oncology
- Medical Imaging
- Genetics
Background:
- Pleuropulmonary blastoma (PPB) is a rare pediatric lung neoplasm.
- PPB can present with associated cysts or neoplasms in other organs.
- PPB is linked to hereditary neoplasia predisposition syndromes in up to 40% of cases.
Purpose of the Study:
- To report a rare case of PPB associated with a jejunal hamartoma.
- To highlight the importance of screening for associated conditions in pediatric PPB.
- To emphasize the role of radiological findings in diagnosing PPB.
Main Methods:
- Case report of a 9-month-old girl with choking episode.
- Incidental findings of lung cyst and iron deficiency anemia.
- Diagnosis of pleuropulmonary blastoma and jejunal hamartoma.
Main Results:
- The patient presented with a lung cyst and anemia, leading to PPB diagnosis.
- This is the eighth reported case of PPB with jejunal hamartoma.
- This is the first radiological report of this association.
Conclusions:
- PPB diagnosis necessitates screening for associated conditions like intestinal polyps.
- Family history of neoplasms or cysts is vital for suspecting PPB.
- Clinicians should screen and follow up patients and relatives with this syndrome.
Abstract:
We report a rare case of 9-month-old girl who presented with a choking episode and was found to have an incidental finding of a lung cyst and iron deficiency anemia leading to the diagnosis of pleuropulmonary blastoma (PPB) and a jejunal hamartoma. Our patient is the eighth that has been reported with the association of PPB with jejunal hamartoma and the first one in the radiological literature. PPB is the pulmonary analog of other dysontogenetic neoplasms in childhood. A biological sequence has been described with the three types of PPB to be interrelated as part of pathologic progression. PPB can be associated with other cysts and/or neoplasms in different organs. PPB is part of a hereditary neoplasia predisposition syndrome in up to 40% of cases. Mutations in DICER gene have been described with PPB. Hence, a pediatric patient diagnosed with PPB should be screened for associated conditions during childhood and adolescence including intestinal polyps. Obtaining family history for other neoplasms or cysts is important information that should raise the possibility of PPB in pediatric patients with cystic lung lesions. The presence of this syndrome should alert the clinician to screen and follow up patients and their relatives.
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