Ex-Utero Intrapartum Treatment (EXIT) in a giant case of Congenital Cystic Adenomatoid Malformation (CCAM) of the lung.
Congenital Cystic Adenomatoid Malformations (CCAM) of the lung are a relatively rare anomaly. The majority of cases do not require any antenatal or perinatal interventions. However, selected cases need special and intensified management. This article discusses a case of a CCAM of the left pulmonary lobe covering 2/3 to 3/4 of the thoracic volume, causing mediastinal shift and hydrops. The enormous size required the planning of an EXIT (Ex Utero-Intrapartum Treatment) procedure, which was performed when the trial of intraoperative ventilation of the lungs was unsuccessful. A thoracotomy and resection of the left upper lobe were performed with the fetus on feto-placental circulation. After resection and closure of the thoracotomy, improvement of lung ventilation allowed the delivery of the child. The child and mother were discharged in a healthy condition. We conclude that the EXIT procedure is a feasible and potentially life-saving method for select cases of prenatally detected CCAM.
Steiner
H
H
Obstetrics and Gynecology, Paracelsus Private Medical University, Salzburg. H.Steiner@salk.at
Boemers
T
T
Forstner
R
R
Ofner
S
S
Lederer
A
A
Ruecker
J
J
D000328:Adult; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000000981:diagnostic imaging* / Q000196:embryology / Q000601:surgery*; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000196:embryology / Q000473:pathology*; D011247:Pregnancy; D016896:Treatment Outcome; D014463:Ultrasonography