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Year : 2000  |  Volume : 10  |  Issue : 4  |  Page : 266-267
Antenatal diagnosis of congenital cystic adenomatoid malformation of the lung (type 1)


Gwalior, Madhya Pradesh, India

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How to cite this article:
Apte A, Kaul R. Antenatal diagnosis of congenital cystic adenomatoid malformation of the lung (type 1). Indian J Radiol Imaging 2000;10:266-7

How to cite this URL:
Apte A, Kaul R. Antenatal diagnosis of congenital cystic adenomatoid malformation of the lung (type 1). Indian J Radiol Imaging [serial online] 2000 [cited 2019 Aug 20];10:266-7. Available from: http://www.ijri.org/text.asp?2000/10/4/266/30580
Sir,

We wish to report a case of congenital cystic adenomatoid malformation (CCAM) of lung (Type 1) diagnosed at 18 weeks of gestation.

A twenty-one-years old primi was referred for a routine obstetric scan. She had no risk factors for congenital anomalies. A clinical examination indicated that she was normal. Real time sonography showed a large multicystic echogenic mass in the fetal thorax on the left side, compressing the heart towards the right side [Figure - 1]. There was evidence of integumentary edema and presence of fetal ascites [Figure - 2]. The amount or liquor was marginally higher. No other congenital anomaly was seen. The patient decided to terminate the pregnancy. Fetal autopsy confirmed the diagnosis of CCAM with hydrops.

CCAM is a rare hamartomatous pulmonary lesion that can be diagnosed prenatally. Large CCAM can displace the mediastinum with compression of the heart and IVC. It may be associated with fetal hydrops, polyhydramnios and pulmonary hypoplasia. There are three types of CCAM of lung.

  1. Large cysts (more than 2 cm).
  2. Smaller cysts (1-2 cm).
  3. Microscopic cysts (appearing solid).


Hydrops secondary to CCAM is almost invariably a lethal condition. This poor prognosis may be attributed to the combined effects of tissue compression from the thoracic space occupying lesions and premature delivery of a hydropic baby following rupture of membranes in the presence of polyhydramnios. In the absence of hydrops or other anomalies, the outcome for the fetuses is excellent with over 90% survival [1],[2]. It also appears that if hydrops is absent at diagnosis, the chance that it will develop as the pregnancy continues is small (about 6%) [2]. Serial sonographic evaluations for CCAM are important. If the fetus develops hydrops, fetal surgery can be considered. If not, fetal surgery should not be done, because lesions can shrink in size or even disappear, while others can be treated successfully after birth by lobectomy or even segmentectomy [3],[4].



 
   References Top

1.Thorpe-beeston JG; Nicolaides KH. Cystic adenomatoid malformation of lung: prenatal diagnosis and outcome. Prenatal Diagnosis 1994; 14: 677-88.   Back to cited text no. 1    
2.Barret J; Chitayat D; Sermer M; Amankwah K; Morrow R; Toi A; Ryan G. The prognostic factors in the prenatal diagnosis ofhe echogenic fetal lung. Prenatal Diagnosis 1995; 15: 849-53.   Back to cited text no. 2    
3.Miller JA; Corteville JE; Langer JC. Congenital cystic adenomatoid malformation in the fetus: natural history and predictors of outcome. Journal of Pediatric Surgery 1996; 31; 805-8   Back to cited text no. 3    
4.Taguchi T; Suita S; Yamanouchi T et al . Antenatal diagnosis and surgical management of congenital cystic adenomatoid malformation of lung. Fetal Diagn Ther. 1995; 10: 400-7.  Back to cited text no. 4    

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Correspondence Address:
Abhay Apte
Gwalior, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


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[Figure - 1], [Figure - 2]



 

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