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 2017-10-22  Case of the week # 457  © Fabrice Cuillier  www.TheFetus.net
Answer to the case of the week # 457
October 26, 2017 - November 9, 2017
 
Fabrice Cuillier,MD.1, Michel J.L., MD2., Doray B.,MD.3, Alessandri J.L.,MD. 4 
1 Service de Gynécologie, Hôpital Félix Guyon, 97400 Saint-Denis, La Réunion. France. 
2  Service de Génétique, Hôpital Félix Guyon, 97400 Saint-Denis, La Réunion. France. 
3 Service de Néonatologie, Hôpital Félix Guyon, 97400 Saint-Denis La Réunion. France. 
4 Service de Néonatologie, Hôpital Félix Guyon, 97400 Saint-Denis La Réunion. France. 
 

Case report

A 26-year-old healthy woman (G2P1) with unremarkable history was referred to our unit for anomaly scan at 23 weeks of pregnancy.
Our ultrasound examinations during the pregnancy revealed findings suggesting cystic adenomatoid malformation.
The patient delivered naturally at 39 weeks of pregnancy.
The postnatal adaptation was difficult and the baby was intubed and operated rapidely (day 2).
Ablation of a left superior pulmonary lobar tumor was done. Post–surgery adaptation was difficult and a second thoractomy was done because of infection with a thoracic drainage. At day 15, the baby was well. 
Anatomo-pathological analysis confirmed our diagnosis of left superior lobar congenital cystic adenomatoid malformation without total spontaneous regression. 

Above, the ultrasound images that we obtained during the gestation:


Image 1, video 1: 
left intra-thoracic lung lesion of solid appearance with micro-cysts.
   
 



Image 2: bilateral diaphragmatic eversion was observed.





Images 3 and 4, video 2: There were no signs of lung sequestration (no aberrant vessel). A complete dextroposition of the heart was seen but cardiac anatomy was normal. Doppler sonography did not showed aberrant vessel. No other associated abnormalities were seen. 

 



Image 5:  heart on the right hemithorax without cardiac failure.





Image 6, video 3: heart on the right hemithorax without cardiac failure.

 



Image 7: the left hyperechoic mass shows mild regression.





Videos 4 and 5:
during the end of the second trimester and the third trimester, we observed a regular and very slowly regression of the left lung lesion.

 



Image 8, video 6: during the end of the second trimester and the third trimester, we observed a regular and very slowly regression of the left lung lesion.

 



Images 9 and 10: during the end of the second trimester and the third trimester, we observed a regular and very slowly regression of the left lung lesion.

 


 
 

 
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