Pediatr Allergy Respir Dis.  2006 Jun;16(2):177-182.

A Case Report of a Patient with Pleuropulmonary Blastoma Presenting as Congenital Cystic Adenomatoid Malformation

• Woo SI
• Kim HB
• Song JS
• Koo HL
• Lim HJ
• Hong SJ

Abstract

Congenital cystic adenomatoid malformation(CCAM) is one of the most common congenital lung lesions. Clinical manifestations that show are neonatal respiratory distress, recurrent respiratory infection, pneumothorax, and hemothorax. But, there are patients who are asymptomatic until mid-childhood. The treatment of asymptomatic CCAM is controversial. There is a possibility to resolve it spontaneously, but late complications such as recurrent pulmonary infection, pneumothorax, hemothorax, and cancer, which includes bronchoalveolar carcinoma and rhabdomyocarcinoma, pleuropulmonary blastoma still remain. Some investigators advocate routine surgery for all cases of CCAM that are apparent at birth. A previously healthy 16-months-old girl who had suffered from a cough for 2 weeks was transferred to Asan Medical Center with CCAM. Due to a chest CT and fever, we first thought that she had CCAM with infection. After we treated her with antibiotics for one week, we performed surgery to confirm the diagnosis and to prevent further complication. But by surgical wedge resection, a pleuropulmonary blastoma was found. There were no evidence of metastasis and adjacent involvement. She started her chemotherapy with vincristine, actinomycin D and cyclophosphamide, and is now continuing maintenance chemotherapy with etoposide, vincristine, and Ifosfamide. We report pleuropulmonary blastoma that presented as CCAM. So we recommend surgical resection in asymptomatic CCAM to confirm the diagnosis and to prevent its malignant transformation, even not accompanied by symptoms.

Keyword

Congenital cystic adenomatoid malformation; Pleuropulmonary blastoma; Children

MeSH Terms

Anti-Bacterial Agents
Child
Chungcheongnam-do
Cough
Cyclophosphamide
Cystic Adenomatoid Malformation of Lung, Congenital*
Dactinomycin
Diagnosis
Drug Therapy
Etoposide
Female
Fever
Hemothorax
Humans
Ifosfamide
Lung
Maintenance Chemotherapy
Neoplasm Metastasis
Parturition
Pneumothorax
Research Personnel
Tomography, X-Ray Computed
Vincristine
Anti-Bacterial Agents
Cyclophosphamide
Dactinomycin
Etoposide
Ifosfamide
Vincristine