[Pulmonary blastoma--long-term survival of a patient with metastases]

We report a rare case of pulmonary blastoma. This 59-year-old woman has been apparently well with recurrent and metastatic tumors in her left lung for 9 years after the initial operation. On May 28, 1984, she underwent a thoracotomy of left upper lobectomy and lymph nodes dissection. The histologic diagnosis of resected specimen was pulmonary blastoma. In August 1986 (27 months after the initial surgery), chest X-ray revealed some nodules in the lungs. Then, the patient had two thoracotomies for the excision of 4 tumors and one chest wall resection of the tumor. In addition, she received systemic chemotherapy 28 times, directly intrapulmonary drug injection 3 times and radiation therapy once for recurrent and metastatic disease. Following some cycles of our combination chemotherapy consisting of cis-platinum and vindesine, some lesions had decreased in size and others previously seen on chest X-ray were no longer evident. She achieved an objective response with receiving two-drug chemotherapy. Our observation suggest that this intensive combination chemotherapy is effective in recurrent and metastatic disease of pulmonary blastoma as a surgical adjuvant.