Thursday, January 6, 2011

Congenital Cystic Adenomatoid Malformation of the Lung

Since the advent of the prenatal ultrasonography we have been able to pick-up a lot of diseases while the baby is in the womb so we can be better prepared to handle them when they are born. CCAM(Congenital Cystic Adenomatoid Malformation) is a rare intrathoracic tumor that is present in the lungs. This occurs in 1 - 25,000 to 35,000 pregnancies. This is usually found during the 20 week gestation and they hare followed closely with repeat ultrasounds. The wonderful thing about this is that 60% resolve at birth. The ones that do not resolve are classified into types. The presenting symptoms at birth depends on the size of the cyst if it is encroaching on the blood vessels or the other organs.
Type I - isolated cyst present in the lungs during the neonatal period
Type II - the cyst in the lung is usually associated with other malformations on the baby
Type III - this is the worse kind because the baby would be born as a fetal hydrops and they do not survive.

If the cyst is significant that baby will be in respiratory distress at birth. The ultimate cure for this is surgical excision. If the baby is asymptomatic and the cyst is small. The pediatric surgeon will follow-up in a few weeks and determine when they are going to operate. Even if the cyst is small this can be a focus of recurrent pneumonia so most surgeons operate on the lesion.


Anonymous said...

Hello, I am 23 weeks pregnant and my baby has been diagnosed with this. I am curious because you have here that 60% of them resolve before birth but all the research I have read states that 10-15% resolve. Do you have new research supporting 60%? It would be a great releif if you do. My baby's cyst was 1cmx1cm last week and grew by 40% this week. I am not sure what to think at this point.

Anonymous said...

I just found out my 15 year old son has CCAM type 1. His lesion on his left lower lobe is 5.4 X 8.0 X 5.2. We found this out while he was hospitalized from a traumatic injury to his chest that broke two ribs and caused him to have a phneumothorax.We have been told it is recommended he have a his left lower lobe removed. In a way I am glad I did not know this when I was pregnant, because my son also has spina bifida; which we also did not know about until he was 4 years old, I was able to blissfully enjoy my pregnancy not knowing what troubles lie ahead. My anxiety level is high,so I understand and feel your concern for your unborn baby. My problem is finding information on kids his age, seems like they find these before they are born or early in life.

Anonymous said...

My 15 year old son had a CAT scan due to a traumatic injury to his chest. He broke three ribs and had a small pneumothorax and they also discovered he had a CCAM in his left lower lobe that is 5.2 X 8.0 X 5.4 in size! I have read that there is a 30% chance that these can develop into cancer, rupture or spontaneous pneumothorax. We are going to have the lobe removed, will the Pathologist be looking for signs of cancer? Who should do his surgery?

Anonymous said...

im pretty sure the cysts are non cancerous. my 2 month old niece has ccam on her lower lobe of her right lung. She will be having surgery to remove the lower lobe within the next month or two.

Tracey Neil said...

We found our son had ccam type 2 when we went for our 20wk scan we then got transfered to Oxford for monitoring and scan every few weeks we were induced at 38wks he was born a healthy 8lb14oz he had slighty rapid breathing and we were kept in for a few days to keep am eye on him he sas back at oxford at 4 weeks for scan then had his op to remove the right lower lobe aat 6months as it can grow bk cancerous after his op which was done keyhole thankfully he was good untill about 8 months old he started getting chronic chest infections phnomonia suffeed very bad asthma it was a very scary time he still get bad asthma now and again atvage 6yrs but a lot less than before he runs and plays football and does boxing he still has some cysts on the top of right lung but can not be removed due to were it is but scan show it is getting smaller I hope our story helps anyone going through this just stay strong and have faith x