A case of treatment-resistant pleuropulmonary blastoma that led to end-of-life at home with home-based palliative care

Abstract

It is important to grant the wish of families of children with malignancy to have end-of-life at home. Pleuropulmonary blastoma in a 3-year-old boy who had a giant mass in the left thorax at presentation relapsed after surgical therapy and high-dose chemotherapy, resulting in life-threatening respiratory failure. The intrathoracic administration of cisplatin and irinotecan was effective, and the patient achieved second remission. After the second relapse occurred, the patient and his parents desired home-based palliative care. After transitioning to home-based care, the parents were reluctant in continuing the therapy. Therefore, we reconfirmed the close information sharing and clear division of roles and responsibilities between the home and hospital doctors. Eventually, the patient died at home surrounded by his family. To grant the patient’s wish of having end-of-life at home, prompt establishment of a close relationship between family members and the home doctor is imperative.