Preoperative Radiation Therapy and Chemotherapy for Pulmonary Blastoma: A Case Report Timothy M. Zagar, MD, Susan Blackwell, MHS, PA-C, Jeffrey Crawford,

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Preoperative Radiation Therapy and Chemotherapy for Pulmonary Blastoma: A Case Report Timothy M. Zagar, MD, Susan Blackwell, MHS, PA-C, Jeffrey Crawford, MD, Thomas D'Amico, MD, Jared D. Christensen, MD, Thomas A. Sporn, MD, Chris R. Kelsey, MD Journal of Thoracic Oncology Volume 5, Issue 2, Pages 282-283 (February 2010) DOI: 10.1097/JTO.0b013e3181c420e1 Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Contrast enhanced chest computed tomography demonstrating the extent of tumor recurrence. Representative axial images with soft tissue windows at the level of the aortic arch (A) and right pulmonary artery (B). The mass is predominantly homogeneous; however, areas of low attenuation suggestive of necrosis are present. There is thickening of the right anterior pleura (arrow). Direct chest wall invasion is not readily identified. The central mass compresses and posteriorly displaces the right pulmonary artery. The mass extends superiorly to the lung apex and inferiorly to the level of the right lower pulmonary vein and closely adheres to the right upper lobectomy staple line (black arrowhead). There is loss of normal mediastinal fat planes (white arrowhead); however, streak artifact from the superior vena cava limits evaluation. The size of the mass and apposition to pericardium, central vessels, and other mediastinal structures are highly suggestive of invasion. Journal of Thoracic Oncology 2010 5, 282-283DOI: (10.1097/JTO.0b013e3181c420e1) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Noncontrast chest computed tomography at the completion of radiation therapy and chemotherapy. Representative axial images at the level of the aortic arch (A) and right pulmonary artery (B) demonstrate marked reduction in tumor size (residual tumor denoted by arrow) with resultant clearing of the mediastinal margins. (Arrowhead denotes prior post upper lobectomy staple line.) Anterior pleural involvement has resolved. Journal of Thoracic Oncology 2010 5, 282-283DOI: (10.1097/JTO.0b013e3181c420e1) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions