Intralobar sequestration associated with cystic adenomatoid malformation: diagnostic and thoracoscopic pitfalls
Background Intralobar sequestration (ILS) associated with congenital cystic adenomatoid malformation (CCAM) is a well-known entity. This hybrid form has many considerations for an appropriate management. This report aims to analyze pitfalls in the diagnosis, treatment, and thoracoscopic procedure pe...
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description | Background
Intralobar sequestration (ILS) associated with congenital cystic adenomatoid malformation (CCAM) is a well-known entity. This hybrid form has many considerations for an appropriate management. This report aims to analyze pitfalls in the diagnosis, treatment, and thoracoscopic procedure pertaining to this association.
Methods
Between May 2004 and September 2007, 23 fetal lung lesions were diagnosed prenatally and managed at the authors’ institution. Seven of these lesions were the hybrid form of ILS-CCAM. The records for these lesions were reviewed retrospectively.
Results
In all seven fetuses, prenatal ultrasound diagnosed congenital lung abnormalities. In three cases, fetal magnetic resonance imaging (MRI) demonstrated a macrocystic lesion supplied by an aberrant vessel. In all cases, the intrauterine evolution remained uncomplicated. All the newborns were asymptomatic at birth. Chest computed tomography (CT) performed at the age of 1 month showed the aberrant vessel in five cases. A regression of the lesion was noted in one patient and that of the aberrant vessel in another patient. Elective thoracoscopic lobectomy of the affected lobe was performed for six patients. The average age at the time of intervention was 5 months. At this writing, one patient is under observation due to resolution of the lesion. The operating time ranged from 80 to 160 min. One conversion to thoracotomy was required. All surgically treated patients had an uneventful hospital course. Histopathologic examination confirmed the association of intralobar sequestration with Stocker type 2 CCAM in five cases and with CCAM type 1 in one case.
Conclusions
Prenatal diagnosis of the ILS-CCAM association was possible, as was resolution of one or both components of this lesion. Preoperative identification of the aberrant vessel is important for prevention of operative morbidity. This should be controlled before the lobectomy is begun. |
doi_str_mv | 10.1007/s00464-008-0183-7 |
format | Article |
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Intralobar sequestration (ILS) associated with congenital cystic adenomatoid malformation (CCAM) is a well-known entity. This hybrid form has many considerations for an appropriate management. This report aims to analyze pitfalls in the diagnosis, treatment, and thoracoscopic procedure pertaining to this association.
Methods
Between May 2004 and September 2007, 23 fetal lung lesions were diagnosed prenatally and managed at the authors’ institution. Seven of these lesions were the hybrid form of ILS-CCAM. The records for these lesions were reviewed retrospectively.
Results
In all seven fetuses, prenatal ultrasound diagnosed congenital lung abnormalities. In three cases, fetal magnetic resonance imaging (MRI) demonstrated a macrocystic lesion supplied by an aberrant vessel. In all cases, the intrauterine evolution remained uncomplicated. All the newborns were asymptomatic at birth. Chest computed tomography (CT) performed at the age of 1 month showed the aberrant vessel in five cases. A regression of the lesion was noted in one patient and that of the aberrant vessel in another patient. Elective thoracoscopic lobectomy of the affected lobe was performed for six patients. The average age at the time of intervention was 5 months. At this writing, one patient is under observation due to resolution of the lesion. The operating time ranged from 80 to 160 min. One conversion to thoracotomy was required. All surgically treated patients had an uneventful hospital course. Histopathologic examination confirmed the association of intralobar sequestration with Stocker type 2 CCAM in five cases and with CCAM type 1 in one case.
Conclusions
Prenatal diagnosis of the ILS-CCAM association was possible, as was resolution of one or both components of this lesion. Preoperative identification of the aberrant vessel is important for prevention of operative morbidity. This should be controlled before the lobectomy is begun.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-008-0183-7</identifier><identifier>PMID: 18855054</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdominal Surgery ; Asymptomatic ; Biological and medical sciences ; Blood Vessels - abnormalities ; Bronchopulmonary Sequestration - diagnostic imaging ; Bronchopulmonary Sequestration - embryology ; Bronchopulmonary Sequestration - etiology ; Bronchopulmonary Sequestration - surgery ; Bronchoscopy ; Cystic Adenomatoid Malformation of Lung, Congenital - complications ; Cystic Adenomatoid Malformation of Lung, Congenital - diagnostic imaging ; Cystic Adenomatoid Malformation of Lung, Congenital - embryology ; Cystic Adenomatoid Malformation of Lung, Congenital - surgery ; Endoscopy ; Female ; Fetuses ; Gastroenterology ; General aspects ; Gestational Age ; Gynecology ; Hepatology ; Histology ; Humans ; Infant, Newborn ; Investigative techniques, diagnostic techniques (general aspects) ; Ligation ; Lung - blood supply ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Newborn babies ; Ostomy ; Patients ; Proctology ; Retrospective Studies ; Surgery ; Thoracic surgery ; Thoracoscopy - methods ; Tomography ; Ultrasonic imaging ; Ultrasonography, Prenatal</subject><ispartof>Surgical endoscopy, 2009-08, Vol.23 (8), p.1750-1753</ispartof><rights>Springer Science+Business Media, LLC 2008</rights><rights>2009 INIST-CNRS</rights><rights>Springer Science+Business Media, LLC 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-8eba6cc4d913f9a1728f10c8f67c42bb03af6a59d92478b6cd853e943a0676603</citedby><cites>FETCH-LOGICAL-c399t-8eba6cc4d913f9a1728f10c8f67c42bb03af6a59d92478b6cd853e943a0676603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-008-0183-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-008-0183-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21798814$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18855054$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zeidan, Smart</creatorcontrib><creatorcontrib>Hery, Geraldine</creatorcontrib><creatorcontrib>Lacroix, Ferderic</creatorcontrib><creatorcontrib>Gorincour, Guillaume</creatorcontrib><creatorcontrib>Potier, Alain</creatorcontrib><creatorcontrib>Dubus, Jean Christophe</creatorcontrib><creatorcontrib>Guys, Jean-Michel</creatorcontrib><creatorcontrib>de Lagausie, Pascal</creatorcontrib><title>Intralobar sequestration associated with cystic adenomatoid malformation: diagnostic and thoracoscopic pitfalls</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Intralobar sequestration (ILS) associated with congenital cystic adenomatoid malformation (CCAM) is a well-known entity. This hybrid form has many considerations for an appropriate management. This report aims to analyze pitfalls in the diagnosis, treatment, and thoracoscopic procedure pertaining to this association.
Methods
Between May 2004 and September 2007, 23 fetal lung lesions were diagnosed prenatally and managed at the authors’ institution. Seven of these lesions were the hybrid form of ILS-CCAM. The records for these lesions were reviewed retrospectively.
Results
In all seven fetuses, prenatal ultrasound diagnosed congenital lung abnormalities. In three cases, fetal magnetic resonance imaging (MRI) demonstrated a macrocystic lesion supplied by an aberrant vessel. In all cases, the intrauterine evolution remained uncomplicated. All the newborns were asymptomatic at birth. Chest computed tomography (CT) performed at the age of 1 month showed the aberrant vessel in five cases. A regression of the lesion was noted in one patient and that of the aberrant vessel in another patient. Elective thoracoscopic lobectomy of the affected lobe was performed for six patients. The average age at the time of intervention was 5 months. At this writing, one patient is under observation due to resolution of the lesion. The operating time ranged from 80 to 160 min. One conversion to thoracotomy was required. All surgically treated patients had an uneventful hospital course. Histopathologic examination confirmed the association of intralobar sequestration with Stocker type 2 CCAM in five cases and with CCAM type 1 in one case.
Conclusions
Prenatal diagnosis of the ILS-CCAM association was possible, as was resolution of one or both components of this lesion. Preoperative identification of the aberrant vessel is important for prevention of operative morbidity. This should be controlled before the lobectomy is begun.</description><subject>Abdominal Surgery</subject><subject>Asymptomatic</subject><subject>Biological and medical sciences</subject><subject>Blood Vessels - abnormalities</subject><subject>Bronchopulmonary Sequestration - diagnostic imaging</subject><subject>Bronchopulmonary Sequestration - embryology</subject><subject>Bronchopulmonary Sequestration - etiology</subject><subject>Bronchopulmonary Sequestration - surgery</subject><subject>Bronchoscopy</subject><subject>Cystic Adenomatoid Malformation of Lung, Congenital - complications</subject><subject>Cystic Adenomatoid Malformation of Lung, Congenital - diagnostic imaging</subject><subject>Cystic Adenomatoid Malformation of Lung, Congenital - embryology</subject><subject>Cystic Adenomatoid Malformation of Lung, Congenital - surgery</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Fetuses</subject><subject>Gastroenterology</subject><subject>General aspects</subject><subject>Gestational Age</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Histology</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Ligation</subject><subject>Lung - blood supply</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Newborn babies</subject><subject>Ostomy</subject><subject>Patients</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Thoracic surgery</subject><subject>Thoracoscopy - methods</subject><subject>Tomography</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Prenatal</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp10VtrFTEQAOAgij1Wf4Avsgj6tjq5bC6-leKlUPBFn8Nskm1TdjfHJAfpvzene7Ag-BSSfDOZzBDymsIHCqA-FgAhRQ-ge6Ca9-oJ2VHBWc8Y1U_JDgyHnikjzsiLUu6gcUOH5-SMaj0MMIgdSVdrzTinEXNXwq9DKG1bY1o7LCW5iDX47nest527LzW6Dn1Y04I1Rd8tOE8pLw_-U-cj3qxpQ6vv6m3K6FJxad9O9rFOOM_lJXnW1hJendZz8vPL5x-X3_rr71-vLi-ue8eNqb0OI0rnhDeUTwapYnqi4PQklRNsHIHjJHEw3jCh9Cid1wMPRnAEqaQEfk7eb3n3OT38yi6xuDDPuIZ0KFYqYRiII3z7D7xLh7y22iyjZmCKGtMQ3ZDLqZQcJrvPccF8bynY4yjsNgrbRmGPo7Cqxbw5JT6MS_CPEafeN_DuBLC41smMq4vlr2NUGa3p0bHNlXa13oT8WOH_X_8D_Nii-Q</recordid><startdate>20090801</startdate><enddate>20090801</enddate><creator>Zeidan, Smart</creator><creator>Hery, Geraldine</creator><creator>Lacroix, Ferderic</creator><creator>Gorincour, Guillaume</creator><creator>Potier, Alain</creator><creator>Dubus, Jean Christophe</creator><creator>Guys, Jean-Michel</creator><creator>de Lagausie, Pascal</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20090801</creationdate><title>Intralobar sequestration associated with cystic adenomatoid malformation: diagnostic and thoracoscopic pitfalls</title><author>Zeidan, Smart ; Hery, Geraldine ; Lacroix, Ferderic ; Gorincour, Guillaume ; Potier, Alain ; Dubus, Jean Christophe ; Guys, Jean-Michel ; de Lagausie, Pascal</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-8eba6cc4d913f9a1728f10c8f67c42bb03af6a59d92478b6cd853e943a0676603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Abdominal Surgery</topic><topic>Asymptomatic</topic><topic>Biological and medical sciences</topic><topic>Blood Vessels - abnormalities</topic><topic>Bronchopulmonary Sequestration - diagnostic imaging</topic><topic>Bronchopulmonary Sequestration - embryology</topic><topic>Bronchopulmonary Sequestration - etiology</topic><topic>Bronchopulmonary Sequestration - surgery</topic><topic>Bronchoscopy</topic><topic>Cystic Adenomatoid Malformation of Lung, Congenital - complications</topic><topic>Cystic Adenomatoid Malformation of Lung, Congenital - diagnostic imaging</topic><topic>Cystic Adenomatoid Malformation of Lung, Congenital - embryology</topic><topic>Cystic Adenomatoid Malformation of Lung, Congenital - surgery</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Fetuses</topic><topic>Gastroenterology</topic><topic>General aspects</topic><topic>Gestational Age</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Histology</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Ligation</topic><topic>Lung - blood supply</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Newborn babies</topic><topic>Ostomy</topic><topic>Patients</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Thoracic surgery</topic><topic>Thoracoscopy - methods</topic><topic>Tomography</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography, Prenatal</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zeidan, Smart</creatorcontrib><creatorcontrib>Hery, Geraldine</creatorcontrib><creatorcontrib>Lacroix, Ferderic</creatorcontrib><creatorcontrib>Gorincour, Guillaume</creatorcontrib><creatorcontrib>Potier, Alain</creatorcontrib><creatorcontrib>Dubus, Jean Christophe</creatorcontrib><creatorcontrib>Guys, Jean-Michel</creatorcontrib><creatorcontrib>de Lagausie, Pascal</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zeidan, Smart</au><au>Hery, Geraldine</au><au>Lacroix, Ferderic</au><au>Gorincour, Guillaume</au><au>Potier, Alain</au><au>Dubus, Jean Christophe</au><au>Guys, Jean-Michel</au><au>de Lagausie, Pascal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intralobar sequestration associated with cystic adenomatoid malformation: diagnostic and thoracoscopic pitfalls</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2009-08-01</date><risdate>2009</risdate><volume>23</volume><issue>8</issue><spage>1750</spage><epage>1753</epage><pages>1750-1753</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Background
Intralobar sequestration (ILS) associated with congenital cystic adenomatoid malformation (CCAM) is a well-known entity. This hybrid form has many considerations for an appropriate management. This report aims to analyze pitfalls in the diagnosis, treatment, and thoracoscopic procedure pertaining to this association.
Methods
Between May 2004 and September 2007, 23 fetal lung lesions were diagnosed prenatally and managed at the authors’ institution. Seven of these lesions were the hybrid form of ILS-CCAM. The records for these lesions were reviewed retrospectively.
Results
In all seven fetuses, prenatal ultrasound diagnosed congenital lung abnormalities. In three cases, fetal magnetic resonance imaging (MRI) demonstrated a macrocystic lesion supplied by an aberrant vessel. In all cases, the intrauterine evolution remained uncomplicated. All the newborns were asymptomatic at birth. Chest computed tomography (CT) performed at the age of 1 month showed the aberrant vessel in five cases. A regression of the lesion was noted in one patient and that of the aberrant vessel in another patient. Elective thoracoscopic lobectomy of the affected lobe was performed for six patients. The average age at the time of intervention was 5 months. At this writing, one patient is under observation due to resolution of the lesion. The operating time ranged from 80 to 160 min. One conversion to thoracotomy was required. All surgically treated patients had an uneventful hospital course. Histopathologic examination confirmed the association of intralobar sequestration with Stocker type 2 CCAM in five cases and with CCAM type 1 in one case.
Conclusions
Prenatal diagnosis of the ILS-CCAM association was possible, as was resolution of one or both components of this lesion. Preoperative identification of the aberrant vessel is important for prevention of operative morbidity. This should be controlled before the lobectomy is begun.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>18855054</pmid><doi>10.1007/s00464-008-0183-7</doi><tpages>4</tpages></addata></record> |
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subjects | Abdominal Surgery Asymptomatic Biological and medical sciences Blood Vessels - abnormalities Bronchopulmonary Sequestration - diagnostic imaging Bronchopulmonary Sequestration - embryology Bronchopulmonary Sequestration - etiology Bronchopulmonary Sequestration - surgery Bronchoscopy Cystic Adenomatoid Malformation of Lung, Congenital - complications Cystic Adenomatoid Malformation of Lung, Congenital - diagnostic imaging Cystic Adenomatoid Malformation of Lung, Congenital - embryology Cystic Adenomatoid Malformation of Lung, Congenital - surgery Endoscopy Female Fetuses Gastroenterology General aspects Gestational Age Gynecology Hepatology Histology Humans Infant, Newborn Investigative techniques, diagnostic techniques (general aspects) Ligation Lung - blood supply Magnetic Resonance Imaging Male Medical sciences Medicine Medicine & Public Health Newborn babies Ostomy Patients Proctology Retrospective Studies Surgery Thoracic surgery Thoracoscopy - methods Tomography Ultrasonic imaging Ultrasonography, Prenatal |
title | Intralobar sequestration associated with cystic adenomatoid malformation: diagnostic and thoracoscopic pitfalls |
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