Fetal lung masses: prenatal course and outcome.

Abstract

We describe 25 cases of echogenic or complex fetal lung masses seen sonographically and suspected of being cystic adenomatoid malformations or sequestrations of the lung. On the basis of prenatal sonographic appearance, 40% of fetuses were suspected of having type 1, 20% type 2, and 403 type 3 cystic adenomatoid malformations or sequestrations. Sixteen (64%) of the 25 fetuses with lung masses survived the perinatal period, and 80% of the nonaborted fetuses survived. Eleven infants (69% of liveboms) had no respiratory symptoms at birth. Nine of the survivors underwent surgical resections of their masses after birth, whereas the other seven children are being followed conservatively. The postnatal diagnoses revealed that four of the fetus· es had sequestrations, one had a sequestration with elements consistent with cystic adenomatoid malformation, and two who were thought to have type 1 cystic adenomatoid malformation had an esophageal duplication cyst and a thoracic neuroblastoma, respectively. All the other infants who had a pathologic diagnosis or postnatal imaging had cystic ade-ABBREVIATIONS CAM, Cystic adenomatoid malfonnation; CT, Computed tomog· raphy; MR, Magnetic resonance

Cystic Adenomatoid Malformation of the Lung: Prenatal Diagnosis, Prognostic Factors and Fetal Outcome

“…Consequently, the lesions were not noticeable by ultrasound at the end of the pregnancy but were demonstrable after birth. These findings conform with those of a recent study comprising pregnancies that were carried out to term, in which a 50% survival rate was reported for pregnancies with type-II CAM and a Golaszewski/Bettelheim/Eppel/Deutinger/ Bernaschek 87% survival rate was reported for those with type-III CAM [17]. In 2 pregnancies with CAM type III that were terminated, we observed severe cardiac deviation which would subsequently have caused hypoplasia of the contralateral lung.…”

Prenatal thoracoabdominal tumor mimicking pulmonary sequestration: a diagnosis dilemma

“…The detection of an echogenic mass in the thoracoabdominal limits (inframediastinal posterior space) suggests the diagnosis of a neuroblastoma, a lung sequestration, a cystic adenomatoid malformation, a lymphangioma, a congenital diaphragmatic hernia, or a bronchial atresia [1,2,3,4,5,6]. We add angioma as another differential diagnosis.…”

“…Thoracoabdominal masses are among the many congenital anomalies being detected in fetus [1,2]. The differential diagnosis of such anomalies include cystic adenomatoid malformation (CAM), pulmonary sequestration (PS), neuroblastoma, lymphangioma, congenital diaphragmatic hernia, and bronchial atresia [3].…”

Are Bilateral Fetal Lung Masses Double Trouble?

“…The prognosis is good if there are no other abnormalities and the lesion does not cause hydrops. In fact, many regress significantly in size during gestation [1][2][3][4], ultimately having little or no physiological effect on the infant. However, the natural history of the rare bilateral fetal cystic lung lesion is unknown [5].…”