Cystic adenomatoid malformation of the lung: clinical evolution and management

Bagolan, Pietro; Nahom, A.; Giorlandino, Claudio; Trucchi, Alessandro; Bilancioni, E.; Inserra, Alessandro; Gambuzza, G.; Spina, V

doi:10.1007/s004310051233

Cited by 36 publications

(26 citation statements)

References 13 publications

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“…Prenatal diagnosis with subsequent surgical intervention leads to a shorter length of stay, a trend towards fewer complications, and decreased medical cost as compared with intervention after symptoms develop, where the lesion was not diagnosed prenatally or was not resected electively. Workup in the asymptomatic patient includes chest X-ray and CT scan to allow more definite assessment of the lesion [40,41].…”

Section: Discussionmentioning

confidence: 99%

Thoracoamniotic Shunts: Fetal Treatment of Pleural Effusions and Congenital Cystic Adenomatoid Malformations

et al. 2004

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Objective: To determine whether fetuses that underwent thoracoamniotic shunt placement for treatment of pleural effusion (PE) or macrocystic congenital cystic adenomatoid malformation (CCAM) have an improved outcome as compared with an untreated population. Methods: A retrospective review from a single tertiary center was performed using thoracoamniotic shunt placement to treat PE or macrocystic CCAM between 1998 and 2001. Thoracoamniotic shunts were used on 26 occasions in 19 pregnancies. Results: The average gestational age at the diagnosis of PE and CCAM was 22 + 4 and 20 + 0 weeks, respectively. Shunts were offered in pregnancies complicated by hydrops or at significant risk for pulmonary hypoplasia. Shunts were placed at 26 + 2 weeks (average) and 23 + 1 weeks (average) in the PE and CCAM groups, respectively. In CCAM patients, the mean pre- and postshunting mass volumes were 50.5 and 25.7 cm³, representing a 51% reduction in mass volume following shunt placement. In the PE group, the average delivery age was 33 + 5 weeks, with an average shunt placement to delivery time of 7 + 3 weeks. In the CCAM group, the average delivery was 33 + 3 weeks, with an average shunt placement to delivery time of 10 + 2 weeks. The postnatal survival rates were 67% (6/9) and 70% (7/10) in the PE and CCAM groups, respectively. Conclusions: (1) Thoracoamniotic shunts should be considered as a treatment option for selected PE or macrocystic CCAM fetuses with hydrops or a significant risk for pulmonary hypoplasia; (2) the neonatal survival with shunting was similar for PE and CCAM groups and was improved as compared with literature reports, and (3) fetuses with CCAM presented earlier with hydrops than those with PE. Successful shunting resulted in a prolongation of pregnancy into the 3rd trimester in both groups.

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Section: Discussionmentioning

confidence: 99%

Thoracoamniotic Shunts: Fetal Treatment of Pleural Effusions and Congenital Cystic Adenomatoid Malformations

et al. 2004

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“…Some authors adopt an early resection strategy to avoid the onset of symptoms [4,15,98,99] since the safety of lung resection during the infantile period has been proven [41,98,100], while others adopt a conservative strategy, recognising the surgical risks and the potential of overtreatment [97,101,102,103], and surgery is only purposed after the patient becomes symptomatic with recurrent infections or pneumothorax [100,104]. Additionally, some authors recognise the potential for spontaneous resolution: in a study of 56 children with an antenatal diagnosis of CPAM, two CPAMs spontaneously resolved postnatally and ten resolved antenatally [104].…”

Section: Managementmentioning

confidence: 99%

Prenatal and Postnatal Management of Congenital Pulmonary Airway Malformation

2016

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Congenital pulmonary airway malformation (CPAM) is one of the most common lung lesions detected prenatally. Despite the research efforts made in the past few years, controversy and lack of clarity in the literature still exist regarding nomenclature, classification, pathogenesis and the management of CPAM. Therefore, it is of greatest importance to delineate the natural history of CPAMs and to create a consensus to guide the management and follow-up of these lesions. This review will focus on classification systems, highlighting the most recent advancements in pathogenesis, and current practice in the prenatal diagnosis of CPAM. Strategies of prenatal management and postnatal management will be reviewed. Long-term follow-up, including lung cancer risk, is discussed and an outcome perspective is presented.

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“…The regression, according to the literature, 6 to 11% of CCAM completely regress in utero [9] and 56% partly regress before birth. It is therefore important to give a period of observation after the diagnosis made.…”

Section: Discussionmentioning

confidence: 84%

“…Overall, fetal prognosis at short term is good. In the absence of anasarca and/or extreme prematurity, the survival rate is almost 100% [9]. The Medical interruption of the pregnancy is the leading cause of mortality in fetuses with CCAM [10].…”

Section: Discussionmentioning

confidence: 99%

Antenatal Diagnosis of Cystic Adenomatoid Malformation of the Lung

O¹

2014

Gynecol Obstet

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The Cystic Adenomatoid Malformation (CCAM) of the lung is rare with a frequency estimated between 1/25 000 and 1/35 000 of pregnancies. It consists of a default of alveoli development associated with an abnormal proliferation of terminal bronchioles giving rise to various sizes of cysts. We report a case of cystic adenomatoid malformation type II of the left lower lobe revealed at 22 weeks of gestation by an acute hydramnios. The fetal karyotype was normal. The presence of fetal anasarca and the severity of the adjacent organs compression have justified the pregnancy interruption which has been strongly recommended by the couple. The autopsy confirmed the diagnostic of cystic adenomatoid malformation associated with a complete hypoplasic right lung.

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Cystic adenomatoid malformation of the lung: clinical evolution and management

Cited by 36 publications

References 13 publications

Thoracoamniotic Shunts: Fetal Treatment of Pleural Effusions and Congenital Cystic Adenomatoid Malformations

Thoracoamniotic Shunts: Fetal Treatment of Pleural Effusions and Congenital Cystic Adenomatoid Malformations

Prenatal and Postnatal Management of Congenital Pulmonary Airway Malformation

Antenatal Diagnosis of Cystic Adenomatoid Malformation of the Lung

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