title: [Congenital cystic adenomatoid malformation. Consequences of prenatal diagnosis].
abstract: BACKGROUND
  Advances in technology and the specialized training of gynecologists in ultrasound have led to an increase in fetal diagnoses. Congenital cystic adenomatoid malformation (CCAM) is of particular interest because of its difficulty in predicting the disease evolution.
  
  
  OBJECTIVE
  To review the cases of prenatal diagnosis of CCAM during the last five years in our hospital, and to analyze their evolution as a consequence of its diagnosis.
  
  
  METHODS
  Retrospective study that reviewed the cases of CCAM between 2005 and 2010 treated in our hospital. We evaluated gestational age, type of CCAM and evolution in at least the first 12 months.
  
  
  RESULTS
  Twenty-one cases were diagnosed (1 for every 2,660 deliveries in our hospital of reference), 3 of them with CCAM type 1 (14.3%), 8 with type 2 (38.1%) and 10 with type 3 (47.6%). Two patients proceeded with a medical interruption of pregnancy; in 11 patients lesions were stable, in eight they disappeared and one fetus suffered severe mediastinal shift with little healthy lung, and died during the first postpartum week. Four of eight cases in which the image disappeared were considered free of disease after birth. Of the 19 cases in which pregnancy was not interrupt, 15 had mediastinal shift and 6 did not; in five of them (83.3%), the image disappeared and only one remained stable. The lesion disappeared in only three cases of the 13 who had mediastinal shift (p < 0.01). Lobectomies were necessary in 8 of 19 cases, four are considered free of the disease and seven are still in follow-up.
  
  
  CONCLUSIONS
  Congenital cystic adenomatoid malformation is a condition in which the council is extremely complex, but most cases evolved favorably. Severe complications such as hydrops are described in up to 25% of all CCAM.
authors.affiliation: Servicio de Obstetriccia y Ginecología, Hospital La Paz, Madrid, España. marxichos@hotmail.com
authors.forename: Marcos Javier
authors.initials: MJ
authors.lastname: Cuerva González
authors.forename: Beatriz
authors.initials: B
authors.lastname: Herrero Ruiz
authors.forename: María del Mar
authors.initials: Mdel M
authors.lastname: Gil Mira
authors.forename: Sara
authors.initials: S
authors.lastname: Iacoponi
authors.forename: Roberto
authors.initials: R
authors.lastname: Rodríguez González
authors.forename: Antonio
authors.initials: A
authors.lastname: González González
mesh_terms: D000328:Adult; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal