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A 2-month-old baby girl with

congenital cystic adenomatoid


malformation: a case report
David Anggara Putra, Sacharissa Ardelia Larasati, Ismiranti Andarini
Department of Child Health, Faculty of Medicine, Sebelas Maret University/
Dr. Moewardi General Hospital, Surakarta

ABSTRACT
Background
Congenital cystic adenomatoid malformation (CCAM) is a rare congenital developmental deformity of
the lower respiratory tract. Its etiology remains unknown. The incidence of CCAM ranging between
1:10,000 and 1:35,000 newborns. The pathological changes of CCAM patients include expansion of
pulmonary lobe or segment, single or multiple cystic shadows, ipsilateral pulmonary tissue
compression and pulmonary hypoplasia.

Objective
To describe the diagnosis and
treatment of congenital cystic Diagnosis and treatment of
adenomatoid malformation. Congenital Cystic Adenomatoid Malformation.

Case
A baby girl admitted to Dr. Moewardi General BABY BREATHLESS
RECURRENT RESPIRATORY
Hospital with breathlessness and recurrent
respiratory tract infection since birth. In physical GIRL TRACT INFECTION

examination revealed tachypnea, nasal flare,


subcostal retraction, late lifted left-sided chest
Physical Examinations
wall movement, bulging, widened intercostal
space, hypersonor in percussion, without
vesicular sound. An X-ray demostrated giant
bullae in the left lung with heart shadow was Tachypnea Nasal Subcostal No vesicular Hyper
Flare retraction sound sonor
displaced to the right. A chest CT scan revealed
multiple air-filled vesicles in the left lung with
different sizes, with the diameter between 3 cm
and 5 cm. Large cystic cavity compressed
mediastinum, pulmonary tissue, and trachea.
An echocardiography showed dextroversion.
She underwent a left thoracotomy and a left
lower bulectomy. Biopsy revealed type 1
congenital cystic adenomatoid malformation
(CCAM). RADIOGRAPHIC FINDINGS

Conclusion
Routine antenatal care with ultrasonography will help in detecting cystic lung lesions, which allows
for proper planning of peripartum and neonatal management. The diagnosis of congenital cystic
adenomatoid malformation (CCAM) is established based on clinical and pathological features,
based on Stocker's classification. In the case of respiratory compromise, resection is indicated and is
curative.
Keyword: congenital cystic adenomatoid malformation, congenital pulmonary Airway
Malformation, pulmonary hypoplasia, congenital malformation