Introduction: Congenital Thoracic Malformations (CTM) include congenital cystic adenomatoid malformation (CCAM), Sequestration and cysts. The incidence of CTM ranges between 1-5:10,000 and 1:35,000 newborns. They pose a risk for recurrent respiratory infection, respiratory distress, pneumothorax and potential malignancy. Surgery is indicated for symptomatic infants. For asymptomatic patients, treatment is controversial.
Objective: To investigate the epidemiology, diagnosis, symptoms, management and outcome of congenital lung cysts.
Methods: A retrospective patient`s file study to investigate the epidemiology and treatment of those lesions, through a search in the digital archive of Sheba Medical Center and Rambam Medical Center.
Results: We reviewed 44 cases over a period of 10 years, 28 of them had CCAM, 9 had sequestration, 6 had overlap lesion, 1 had bronchogenic cyst.
31 cases were diagnosed antenatal, 5 of them were diagnosed postnatally in the first months of life.
Over the pregnancy period, 6 fetuses had intrauterine intervention.
15 of the cases were symptomatic, all of them underwent surgery. the risk of being symptomatic is higher in Sequestration over CCAM (RR=2.67, P=0.0085). Males have a trend to increased risk of sequestration (RR=6.09, P=0.07).
Median age for surgery was 11 month for symptomatic cases, 10 month for asymptomatic cases.
Postoperative complication included pneumothorax (11.4%), pleural effusion (n=3), fever (n=2). 15 Patients (34%) diagnosed with HRAD with recurrent wheezing, abnormal obstructive spirometry and a good response to Bronchodilators.
Conclusions: Operation should be considered promptly in Sequestration. Those patients should be in a follow up of pediatric pulmonologist also due to higher rate of HRAD. Further study is needed to determine the exact timing for surgery in the asymptomatic cases.
