Congenital cystic adenomatoid malformation of the lung (CCAM), a retrospective clinical audit and literature review in a tertiary centre in Scotland over a period of 14 years.
This work was a retrospective audit of CCAM - 1994 to 2008. A total of 26 cases were identified. Mean gestational age at diagnosis was 20 weeks. All were unilateral and had serial scans. In 31% the lesion resolved, 8% decreased, 42% were unchanged and 4% increased in size. Only one foetus developed hydrops. All were born alive. Of 8 foetuses where the CCAM was thought to have resolved, 6 had persistent lesions (overall sensitivity and PPV of US 64% and 69%, respectively). Computerised tomography performed better than chest X-ray in detecting lesions postnatally (sensitivity 100% vs 88%, PPV 95% vs 78%). Seventeen cases required surgery, 4 conservative management and 2 were discharged following negative CXR; 12% had associated anomalies. Four babies had recurrent chest infections. CCAMs have a good overall prognosis. CT scan rather than CXR should be performed to confirm the resolution of antenatally diagnosed lesions. Surgical management is the preferred option over conservative management.
a Department of Obstetrics & Gynaecology , Queens Mother's Hospital , Glasgow , UK (Now Merged with Southern General Hospital, Glasgow).
Ambrin Gull
AG
Shamas
a Department of Obstetrics & Gynaecology , Queens Mother's Hospital , Glasgow , UK (Now Merged with Southern General Hospital, Glasgow).
Karishma
K
Bohara
D054869:Clinical Audit; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D005260:Female; D005333:Fetus / Q000000981:diagnostic imaging / Q000473:pathology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000000981:diagnostic imaging / Q000196:embryology / Q000473:pathology; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D011379:Prognosis; D011859:Radiography / Q000379:methods*; D012189:Retrospective Studies; D012606:Scotland; D012680:Sensitivity and Specificity; D062606:Tertiary Care Centers; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
Bronchopulmonary sequestration; congenital bronchopulmonary malformation; congenital cystic adenomatoid malformation of lung; pulmonary hypoplasia