SPONTANEOUS INVOLUTION OF PULMONARY SEQUESTRATION IN CHILDREN - A REPORT OF 2 CASES AND REVIEW OF THE LITERATURE

Background. Two cases of pulmonary sequestration which regressed spont aneously are presented. Objective. To demonstrate the value of imaging studies in the diagnosis and follow-up of some forms of congenital ma sses of the lung in asymptomatic patients. Material and methods, We re viewed the clinical records and imaging studies of two asymptomatic ch ildren, one newborn and the other 3 months old, with thoracic masses w hich demonstrated variable degrees of spontaneous involution. Results. Abdominal ultrasound performed on the newborn with a palpable mass sh owed a triangular echogenic mass with a large central feeding vessel a rising from the aorta. The mass had disappeared on follow-up US exam p erformed 6 years later. CT was performed in the 3-month-old patient wi th a persistent retrocardiac mass. A soft-tissue density mass in the l eft pulmonary base with a large feeding vessel arising from the aorta was visualised on contrast-enhanced CT. Five years later, a new CT sca n showed significant shrinkage of the mass and no vessel. Conclusion. Radiological techniques such as real-time US with Doppler imaging and contrast-enhanced CT may establish the diagnosis of pulmonary sequestr ation by demonstrating the mass and its systemic vessel, thereby elimi nating the need for more aggressive imaging procedures. Partial or tot al disappearance of these masses represents a further example of invol utive pathology and suggests that not all cases of pulmonary sequestra tion should be surgically treated.