ANTENATAL DIAGNOSIS AND SURGICAL-MANAGEMENT OF CONGENITAL CYSTIC ADENOMATOID MALFORMATION OF THE LUNG

We experienced 12 cases of congenital cystic adenomatoid malformation of the lung (CCAM) including 6 cases diagnosed antenatally. They were classified into three groups according to the clinical manifestations. Group A was associated with hydrops fetalis (n = 3), group B presente d with respiratory distress symptoms after birth (n = 6), and group C showed no respiratory symptoms (n = 3). All cases of group A were lost because of hydrops and respiratory failure due to pulmonary hypoplasi a. Because a compression of the mass is thought to be a cause of hydro ps, this group is considered to be a good indication for fetal treatme nt. All cases of group B showed progressive respiratory symptoms a few days after birth which were successfully treated surgically. In 2 of 3 cases of group C, the lesions decreased in size both antenatally and postnatally. We conclude that serial sonographic evaluations for feta l CCAM are important. If the fetus develops hydrops, fetal surgery is to be considered. If not, however, fetal surgery should not be done, b ecause some lesions can shrink in size, or even disappear, while other s can be treated successfully after birth by lobectomy or even segment ectomy.