Abstract
Background: A paucity of evidence regarding the natural history of CCAM and PS has resulted in a divergence in management strategy of asymptomatic cases.
Methods: Retrospective review of all cases referred to a single institution from 1996 and followed-up for at least 5 years. Study entry required prenatal identification of a cystic lung lesion on ultrasound scan and confirmation of CCAM/PS on postnatal CT imaging.
Results: 51 (43%) patients were managed surgically; 8 (6.7%) as a neonatal emergency. Indications for elective surgery included: concerning features on CT, 6 (5.1%); medical advice, 20 (17%); other, 6 (5%). Recurrent respiratory infection was the indication in 11 (9.2%) with a median age at surgery of 1.6 years (range 0.4 to 4.6 years). No cases of malignancy were identified on histological examination.
68 (57%) patients were managed conservatively for a median period of 9.9 years (range 5.2 years to 18 years). Of these patients 52 (76%) continue follow-up and remain asymptomatic. Sixteen patients are not followed-up; 4 (5.9%) following spontaneous resolution and 12 (17%) for other reasons.
Conclusion: Conservative management of asymptomatic CCAM and PS is a reasonable option during the paediatric period.The risk of recurrent infection is <10% and declines following the second year [figure 1],spontaneous resolution is possible and malignancy was not described in this series.
- Copyright ©the authors 2016