title: Congenital adenomatoid disease of the lung: prenatal diagnosis and perinatal management
abstract: Prenatal ultrasonographic (US) detection of congenital adenomatoid malformation (CAM) was made in 18 fetuses at 17 - 36 weeks' gestation and managed in our institution during a 10-year period (1985-1994). The lesion was left-sided in 13 cases, right-sided in 4, and bilateral in 1. According to Stocker's classification, 12 cases were type I, 4 type II, and 2 type III. The prenatal course was followed with serial US examinations in 13 cases; the size of the lesion was stable in 8 and decreased in 5. Mediastinal shift was usually observed, and amniotic fluid volume was increased in 4 cases. One fetus was aborted. Six infants presented with respiratory distress syndrome and required neonatal surgery; delayed surgery was performed in 9 cases. Spontaneous regression of the lesion was observed on follow-up in 2 cases. Surgery consisted in lobectomy in 8 cases and segmentectomy in 6. The presence of fetal hydrops, type III lesions, and bilateral lung involvement are prenatal factors known to be associated with a poor prognosis. However, this series and a review of the literature suggest that caution should be observed with regard to the initial impression when counseling the parents regarding prognosis.
authors.affiliation: Department of Pediatric Surgery, Saint Vincent De Paul's Hospital, 78 - 82, avenue Denfort-Rochereon, F-75674 Paris Cedex 14, France
authors.initials: E
authors.lastname: Sapin
authors.initials: V
authors.lastname: Lejeune
authors.initials: JP
authors.lastname: Barbet
authors.initials: E
authors.lastname: Carricaburu
authors.initials: F
authors.lastname: Lewin
authors.initials: JM
authors.lastname: Baron
authors.initials: F
authors.lastname: Barbotin-Larrieu
authors.initials: PG
authors.lastname: Helardot