Hindawi Publishing Corporation Case Reports in Medicine Volume 2012, Article ID 471613, 4 pages doi:10.1155/2012/471613 Case Report Pulmonary Blastoma: A Rare Primary Lung Malignancy Mahmoud S. Alahwal,1 Iqbal H. Maniyar,1 Faiza Saleem,1 and Mariam Alshiekh2 1 Medical Oncology, Faculty of Medicine, King Abdulaziz University, Jeddah 22254, Saudi Arabia 2 Faculty of Medicine, King Abdulaziz University, Jeddah 22254, Saudi Arabia Correspondence should be addressed to Faiza Saleem, faizasal@gmail.com Received 17 July 2012; Accepted 16 August 2012 Academic Editor: Ting Fan Leung Copyright © 2012 Mahmoud S. Alahwal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Pulmonary blastoma, a rare primary lung malignancy, is considered to be distinct from other lung tumors based on pathological features, clinical course, and prognosis. More than one hundred cases have been reported in literature highlighting an interesting fact about their distinctive biologic manner from histopathological features. Classic pulmonary blastoma is composed of a mixture of immature epithelial and mesenchymal tissue resembling fetal lung tissue. Surgery is the mainstay of treatment. The prognosis of this rare malignancy is poor and the overall 5-year survival is around 15%. Our patient presented with respiratory symptoms and was found to have right-sided chest wall mass. The patient underwent complete surgical excision followed by 6 cycles of platinum- based chemotherapy. The patient showed good subjective and objective response with no evidence of disease recurrence. We report this rare malignancy with a review of literature, and the potential to use adjuvant chemotherapy in the management of this condition. 1. Introduction Pulmonary blastoma (PB) is classiﬁed as one of the rare primary lung malignancies and is considered to be distinct from other lung tumors based on pathological features, clinical course and prognosis. PB is composed of a mixture of epithelial and mesenchymal tissues resembling embryonic lung tissue. Surgery is the standard treatment and the eﬃcacy of adjuvant chemotherapy and radiotherapy has not yet been established. Platinum-based chemotherapy has been used with or without postoperative radiotherapy. The prognosis of this rare tumor is poor. We describe a case of this rare pulmonary malignancy and the role of adjuvant chemotherapy in the management and outcome. 2. Case Report A 16-year-old young Egyptian female presented with pro- gressive shortness of breath over a period of ﬁve years. The dyspnea was gradual in onset, at times precipitated by stress, but most of the time there was no precipitating factor. It was associated with severe nonproductive cough and bilateral headache. There was no signiﬁcant past medical history. There was no history of fever, night sweats, and wheeze or chest pain. Also, there was no hoarseness of voice or hemop- tysis. The patient sought medical advice at a private health center when the patient’s daily activities gradually started getting aﬀected. The patient was prescribed Salbutamol inhaler which gave her temporary relief. At the same time, the patient was diagnosed to have hyperthyroidism and was started on carbimazole. The patient took these medications for about 4 weeks and discontinued them against medical advice as she experienced lethargy and easy fatigability due to the sideeﬀects of the prescribed drugs. After a brief period of relief of symptoms, the patient again started to have dyspnea and presented to the Cardio- thoracic Unit in our hospital for evaluation. Baseline inves- tigations were done, which included complete blood count, renal function tests, and liver function tests; all were within the normal range. Chest X-ray showed a well-demarcated right upper lobe mass close to hilum (Figure 1). Chest computed tomography (CT) scan showed bilateral thyroid nodules and a large well-deﬁned heterogeneously enhancing mass measuring 11 × 6 cm with a central hypodensity at the right upper lobe with signiﬁcant compression to the superior vena cava (Figure 2). There was no evidence of signiﬁcant