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Congenital Cystic Adenomatoid Malformation

Impact of Prenatal Diagnosis and Changing Strategies in the Treatment of the Asymptomatic Patient

Kelley W. Marshall1,2, Caroline E. Blane1, Daniel H. Teitelbaum3 and Kathy van Leeuwen3

1 Department of Radiology, University of Michigan Health Systems, 1500 E. Medical Center Dr., F-3503, Ann Arbor, MI 48109-0252.
2 Present address: Department of Radiology, Children's Healthcare of Atlanta, 1001 Johnson Ferry Rd. N.E., Atlanta, GA 30342-1600.
3 Department of Surgery, University of Michigan Health Systems, Ann Arbor, MI 48109-0252.



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  		Fig. 1A. —Female patient with congenital cystic adenomatoid malformation. Axial prenatal sonogram obtained at 22 weeks' gestational age shows echogenic right-sided fetal lung mass with dominant cyst measuring greater than 1 cm. Findings are compatible with Stocker type I cystic adenomatoid malformation.

 


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  		Fig. 1B. —Female patient with congenital cystic adenomatoid malformation. Chest radiograph obtained at 1 day of life shows triangular right middle lobe opacity with central dominant cyst measuring 4 cm. Patient is asymptomatic.

 


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  		Fig. 2. —1-day-old symptomatic female neonate with prenatal diagnosis of Stocker type I congenital cystic adenomatoid malformation. Patient presented with tachypnea and bradycardia after birth. Supine chest radiograph shows opacification of left upper lobe with rightward deviation of trachea and esophagus delineated by enteric tube. Fetal thoracentesis had been performed in this patient to drain fluid from this giant unilocular malformation. Fluid had reaccumulated resulting in mass effect and homogeneous opacity seen on this radiograph.

 

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