Çocuk Sağlığı ve Hastalıkları Dergisi
2013 , Vol 56 , Num 2
Postnatal follow-up of infants diagnosed with congenital cystic adenomatoid malformation prenatally
Hacettepe Üniversitesi Tıp Fakültesi 1Pediatri Araştırma Görevlisi, 2Pediatri Uzmanı,3Kadın Hastalıkları ve Doğum Uzmanı,
4Kadın Hastalıkları ve Doğum Doçenti, 5Pediatri Profesörü, 6Pediatri Doçenti
*İletişim: ozgeonay79@gmail.com
Congenital cystic adenomatoid malformation (CCAM) is a congenital
hamartomatous lesion of the lung, characterized by aberrant proliferation of
terminal bronchioles together with various cystic and solid structures. This
entity was renamed recently as congenital pulmonary airway malformations
(CPAM). Ultrasonography is the chief modality for prenatal diagnosis between
16-32 weeks of pregnancy. Polyhydramnios, hydrops, pulmonary hypoplasia,
and mediastinal shift can also be detected synchronously. In this study, we
evaluated retrospectively the records of infants prenatally diagnosed with
CPAM who were hospitalized between 2001 and 2012 in Hacettepe University
İhsan Doğramacı Children’s Hospital, Neonatal Intensive Care Unit. Prenatal
diagnosis and postnatal outcome were compared. In the last 10 years, nine
neonates were born with a prenatal CPAM diagnosis. 66.7% of the infants
were asymptomatic. Complications such as polyhydramnios, hydrops, pulmonary
hypoplasia, and mediastinal shift were not observed in any of the cases.
The mean follow-up period was 3±3.7 years; two cases dropped out in the
long-term follow-up. Postnatally, two cases were diagnosed with pulmonary
sequestration (22.2%), one with CCAM type 1 (11.1%), one with thymic
cyst (11.1%), one with bronchogenic cyst (11.1%), and one with congenital
lobar emphysema (11.1%). Spontaneous resolution of the cysts was observed
in two cases. As a result of recurrent pneumonia, lobectomy was performed
in one case; it was diagnosed pathologically as CCAM type I. There was
no mortality. In conclusion, although discrepancies exist between antenatal
and postnatal diagnoses, ultrasonography has an important role in both the
diagnosis and management of CPAM.
Anahtar Kelimeler :
konjenital kistik adenomatoid malformasyon, konjenital pulmoner
hava yolu malformasyonu, yenidoğan, ultrasonografi.