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Chapter 11 - Lung Masses

from Section 3

Published online by Cambridge University Press:  19 November 2021

Olutoyin A. Olutoye
Affiliation:
Ann & Robert H. Lurie Children's Hospital of Chicago, Illinois
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Summary

Prenatally diagnosed congenital lung malformations represent a wide variety of fetal pulmonary and airway anomalies, some of which may require close monitoring and perinatal follow-up. Historically these masses were only typically seen when they were very large, at which point they were associated with a high incidence of hydrops and a high termination rate; therefore a diagnosis of a fetal lung mass had a guarded prognosis. Widespread use of prenatal ultrasound improved detection of these masses and advances in surgical techniques have allowed for intervention in the fetal period. More recently, a better understanding of fetal physiology and the use of prenatal steroids has reduced the number of fetuses requiring in-utero intervention. When indicated, in-utero treatment requires a multidisciplinary approach with close attention given to the fetal physiology, risk of maternal complications, and unique anesthetic considerations.

Type
Chapter
Information
Anesthesia for Maternal-Fetal Surgery
Concepts and Clinical Practice
, pp. 152 - 167
Publisher: Cambridge University Press
Print publication year: 2021

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References

Fowler, DJ, Gould, SJ. The pathology of congenital lung lesions. Semin Pediatr Surg. 2015;24(4):176182.Google Scholar
Kim, YT, Kim, JS, Park, JD, et al. Treatment of congenital cystic adenomatoid malformation–does resection in the early postnatal period increase surgical risk? Eur J Cardiothorac Surg. 2005;27(4):658661.Google Scholar
Cass, DL, Olutoye, OO, Cassady, CI, et al. Prenatal diagnosis and outcome of fetal lung masses. J Pediatr Surg. 2011;46(2):292298.Google Scholar
Correia-Pinto, J, Gonzaga, S, Huang, Y, Rottier, R. Congenital lung lesions–underlying molecular mechanisms. Semin Pediatr Surg. 2010;19(3):171179.Google Scholar
Mullassery, D, Smith, NP. Lung development. Semin Pediatr Surg. 2015;24(4):152155.CrossRefGoogle ScholarPubMed
Herriges, M, Morrisey, EE. Lung development: orchestrating the generation and regeneration of a complex organ. Development. 2014;141(3):502513.Google Scholar
Chen, F, Desai, TJ, Qian, J, et al. Inhibition of Tgf beta signaling by endogenous retinoic acid is essential for primary lung bud induction. Development. 2007;134(16):29692979.Google Scholar
Mendelsohn, C, Mark, M, Dolle, P, et al. Retinoic acid receptor beta 2 (RAR beta 2) null mutant mice appear normal. Dev Biol. 1994;166(1):246258.Google Scholar
Miura, T. Modeling lung branching morphogenesis. Curr Top Dev Biol. 2008;81:291310.Google Scholar
Metzger, RJ, Klein, OD, Martin, GR, Krasnow, MA. The branching programme of mouse lung development. Nature. 2008;453(7196):745750.CrossRefGoogle ScholarPubMed
Boucherat, O, Jeannotte, L, Hadchouel, A, et al. Pathomechanisms of congenital cystic lung diseases: focus on congenital cystic adenomatoid malformation and pleuropulmonary blastoma. Paediatr Respir Rev. 2016;19:6268.Google Scholar
Burri, PH. Structural aspects of postnatal lung development – alveolar formation and growth. Biol Neonate. 2006;89(4):313322.CrossRefGoogle ScholarPubMed
Kitaoka, H, Burri, PH, Weibel, ER. Development of the human fetal airway tree: analysis of the numerical density of airway endtips. Anat Rec. 1996;244(2):207213.Google Scholar
Wilkinson, GA, Schittny, JC, Reinhardt, DP, Klein, R. Role for ephrinB2 in postnatal lung alveolar development and elastic matrix integrity. Dev Dyn. 2008;237(8):22202234.Google Scholar
Morotti, RA, Cangiarella, J, Gutierrez, MC, et al. Congenital cystic adenomatoid malformation of the lung (CCAM): evaluation of the cellular components. Hum Pathol. 1999;30(6):618625.CrossRefGoogle ScholarPubMed
Cass, DL, Quinn, TM, Yang, EY, et al. Increased cell proliferation and decreased apoptosis characterize congenital cystic adenomatoid malformation of the lung. J Pediatr Surg. 1998;33(7):1043–6; discussion 7.Google Scholar
Swarr, DT, Peranteau, WH, Pogoriler, J, et al. Novel molecular and phenotypic insights into congenital lung malformations. Am J Respir Crit Care Med. 2018;197(10):13281339.Google Scholar
Harfe, BD, Scherz, PJ, Nissim, S, et al. Evidence for an expansion-based temporal Shh gradient in specifying vertebrate digit identities. Cell. 2004;118(4):517528.Google Scholar
Harris, KS, Zhang, Z, McManus, MT, et al. Dicer function is essential for lung epithelium morphogenesis. Proc Natl Acad Sci USA. 2006;103(7):22082213.Google Scholar
Shanmugam, G, MacArthur, K, Pollock, JC. Congenital lung malformations–antenatal and postnatal evaluation and management. Eur J Cardiothorac Surg. 2005;27(1):4552.Google Scholar
Adzick, NS. Management of fetal lung lesions. Clin Perinatol. 2009;36(2):363–76, x.Google Scholar
Stocker, JT, Madewell, JE, Drake, RM. Congenital cystic adenomatoid malformation of the lung. Classification and morphologic spectrum. Hum Pathol. 1977;8(2):155171.Google Scholar
Stocker, JT. Congenital and developmental diseases. In: Dail, DH Hammar SP, eds. Pulmonary Pathology. Springer; 2008, pp. 154–80.Google Scholar
Adzick, NS, Harrison, MR. Management of the fetus with a cystic adenomatoid malformation. World J Surg. 1993;17(3):342349.Google Scholar
Azizkhan, RG, Crombleholme, TM. Congenital cystic lung disease: contemporary antenatal and postnatal management. Pediatr Surg Int. 2008;24(6):643657.Google Scholar
Riley, JS, Urwin, JW, Oliver, ER, et al. Prenatal growth characteristics and pre/postnatal management of bronchopulmonary sequestrations. J Pediatr Surg. 2018;53(2):265269.Google Scholar
Mubang, R, Brady, JJ, Mao, M, et al. Intradiaphragmatic bronchogenic cysts: case report and systematic review. J Cardiothorac Surg. 2016;11(1):79.Google Scholar
Ramsay, BH, Byron, FX. Mucocele, congenital bronchiectasis, and bronchiogenic cyst. J Thorac Surg. 1953;26(1):2130.CrossRefGoogle ScholarPubMed
Kinsella, D, Sissons, G, Williams, MP. The radiological imaging of bronchial atresia. Br J Radiol. 1992;65(776):681685.Google Scholar
Wang, Y, Dai, W, Sun, Y, et al. Congenital bronchial atresia: diagnosis and treatment. Int J Med Sci. 2012;9(3):207212.Google Scholar
Zamora, IJ, Sheikh, F, Olutoye, OO, et al. Mainstem bronchial atresia: a lethal anomaly amenable to fetal surgical treatment. J Pediatr Surg. 2014;49(5):706711.Google Scholar
Mourya, M, Meena, DS. Congenital lobar emphysema: an approach of anesthetic management. J Clin Diagn Res. 2016;10(8):UD013.Google Scholar
Pariente, G, Aviram, M, Landau, D, Hershkovitz, R. Prenatal diagnosis of congenital lobar emphysema: case report and review of the literature. J Ultrasound Med. 2009;28(8):10811084.Google Scholar
Aslan, H, Ekiz, A, Acar, DK, et al. Prenatal diagnosis of congenital high airway obstruction syndrome (CHAOS). Five case report. Med Ultrason. 2015;17(1):115118.Google Scholar
Vidaeff, AC, Szmuk, P, Mastrobattista, JM, et al. More or less CHAOS: case report and literature review suggesting the existence of a distinct subtype of congenital high airway obstruction syndrome. Ultrasound Obstet Gynecol. 2007;30(1):114117.CrossRefGoogle ScholarPubMed
Chowdhury, MM, Chakraborty, S. Imaging of congenital lung malformations. Semin Pediatr Surg. 2015;24(4):168175.Google Scholar
Kane, SC, Da Silva Costa, F, Crameri, JA, et al. Antenatal assessment and postnatal outcome of fetal echogenic lung lesions: a decade’s experience at a tertiary referral hospital. J Matern Fetal Neonatal Med. 2019;32(5):703709.Google Scholar
MacGillivray, TE, Harrison, MR, Goldstein, RB, Adzick, NS. Disappearing fetal lung lesions. J Pediatr Surg. 1993;28(10):13211324; discussion 4–5.CrossRefGoogle ScholarPubMed
Meagher, SE, Fisk, NM, Harvey, JG, et al. Disappearing lung echogenicity in fetal bronchopulmonary malformations: a reassuring sign? Prenat Diagn. 1993;13(6):495501.CrossRefGoogle ScholarPubMed
Cavoretto, P, Molina, F, Poggi, S, et al. Prenatal diagnosis and outcome of echogenic fetal lung lesions. Ultrasound Obstet Gynecol. 2008;32(6):769783.Google Scholar
Hadchouel, A, Benachi, A, Delacourt, C. Outcome of prenatally diagnosed bronchial atresia. Ultrasound Obstet Gynecol. 2011;38(1):119; author reply -20.Google Scholar
Kunisaki, SM, Ehrenberg-Buchner, S, Dillman, JR, et al. Vanishing fetal lung malformations: Prenatal sonographic characteristics and postnatal outcomes. J Pediatr Surg. 2015;50(6):978982.Google Scholar
Adzick, NS, Harrison, MR, Crombleholme, TM, et al. Fetal lung lesions: management and outcome. Am J Obstet Gynecol. 1998;179(4):884889.Google Scholar
Crombleholme, TM, Coleman, B, Hedrick, H, et al. Cystic adenomatoid malformation volume ratio predicts outcome in prenatally diagnosed cystic adenomatoid malformation of the lung. J Pediatr Surg. 2002;37(3):331338.Google Scholar
Ehrenberg-Buchner, S, Stapf, AM, Berman, DR, et al. Fetal lung lesions: can we start to breathe easier? Am J Obstet Gynecol. 2013;208(2):151 e17.Google Scholar
Feghali, M, Jean, KM, Emery, SP. Ultrasound assessment of congenital fetal lung masses and neonatal respiratory outcomes. Prenat Diagn. 2015;35(12):12081212.Google Scholar
Mahle, WT, Rychik, J, Tian, ZY, et al. Echocardiographic evaluation of the fetus with congenital cystic adenomatoid malformation. Ultrasound Obstet Gynecol. 2000;16(7):620624.Google Scholar
Peranteau, WH, Boelig, MM, Khalek, N, et al. Effect of single and multiple courses of maternal betamethasone on prenatal congenital lung lesion growth and fetal survival. J Pediatr Surg. 2016;51(1):2832.Google Scholar
Curran, PF, Jelin, EB, Rand, L, et al. Prenatal steroids for microcystic congenital cystic adenomatoid malformations. J Pediatr Surg. 2010;45(1):145150.Google Scholar
Morris, LM, Lim, FY, Livingston, JC, et al. High-risk fetal congenital pulmonary airway malformations have a variable response to steroids. J Pediatr Surg. 2009;44(1):6065.Google Scholar
Miller, JA, Corteville, JE, Langer, JC. Congenital cystic adenomatoid malformation in the fetus: natural history and predictors of outcome. J Pediatr Surg. 1996;31(6):805808.Google Scholar
Litwinska, M, Litwinska, E, Janiak, K, et al. Thoracoamniotic shunts in macrocystic lung lesions: case series and review of the literature. Fetal Diagn Ther. 2017;41(3):179183.Google Scholar
Schrey, S, Kelly, EN, Langer, JC, et al. Fetal thoracoamniotic shunting for large macrocystic congenital cystic adenomatoid malformations of the lung. Ultrasound Obstet Gynecol. 2012;39(5):515520.Google Scholar
Wilson, RD, Johnson, MP. Prenatal ultrasound guided percutaneous shunts for obstructive uropathy and thoracic disease. Semin Pediatr Surg. 2003;12(3):182189.Google Scholar
Wittman, BK, Martin, KA, Wilson, RD, Peacock, D. Complications of long-term drainage of fetal pleural effusion: case report and review of the literature. Am J Perinatol. 1997;14(8):443447.Google Scholar
Davenport, M, Warne, SA, Cacciaguerra, S, et al. Current outcome of antenally diagnosed cystic lung disease. J Pediatr Surg. 2004;39(4):549556.Google Scholar
Parikh, DH, Rasiah, SV. Congenital lung lesions: Postnatal management and outcome. Semin Pediatr Surg. 2015;24(4):160167.Google Scholar
Shin, H, Kim, E, Hwang, J, et al. Comparison of upper airway patency in patients with mild obstructive sleep apnea during dexmedetomidine or propofol sedation: a prospective, randomized, controlled trial. BMC Anesthesiol. 2018;18:120.Google Scholar
Harrison, MR, Adzick, NS, Jennings, RW, et al. Antenatal intervention for congenital cystic adenomatoid malformation. Lancet. 1990;336(8721):965967.Google Scholar
Adzick, NS, Harrison, MR, Flake, AW, et al. Fetal surgery for cystic adenomatoid malformation of the lung. J Pediatr Surg. 1993;28(6):806812.Google Scholar
Jancelewicz, T, Harrison, MR. A history of fetal surgery. Clin Perinatol. 2009;36(2):227236, vii.Google Scholar
Cass, DL, Olutoye, OO, Ayres, NA, et al. Defining hydrops and indications for open fetal surgery for fetuses with lung masses and vascular tumors. J Pediatr Surg. 2012;47(1):4045.Google Scholar
Boat, A, Mahmoud, M, Michelfelder, EC, et al. Supplementing desflurane with intravenous anesthesia reduces fetal cardiac dysfunction during open fetal surgery. Paediatr Anaesth. 2010;20(8):748756.Google Scholar
Donepudi, R, Huynh, M, Moise, KJ Jr., et al. Early administration of magnesium sulfate during open fetal myelomeningocele repair reduces the dose of inhalational anesthesia. Fetal Diagn Ther. 2019;45(3):192196. doi: 10.1159/000487883.Google Scholar
Ferschl, M, Ball, R, Lee, H, Rollins, MD. Anesthesia for in utero repair of myelomeningocele. Anesthesiology. 2013;118(5):12111223. doi: 10.1097/ALN.0b013e31828ea597.Google Scholar
Adzick, NS. Open fetal surgery for life-threatening fetal anomalies. Semin Fetal Neonatal Med. 2010;15(1):18.Google Scholar
Abraham, RJ, Sau, A, Maxwell, D. A review of the EXIT (Ex utero Intrapartum Treatment) procedure. J Obstet Gynaecol. 2010;30(1):15.Google Scholar
Al-Refai, A, Ryan, G, Van Mieghem, T. Maternal risks of fetal therapy. Curr Opin Obstet Gynecol. 2017;29(2):8084.Google Scholar
Cass, DL, Olutoye, OO, Cassady, CI, et al. EXIT-to-resection for fetuses with large lung masses and persistent mediastinal compression near birth. J Pediatr Surg. 2013;48(1):138144.Google Scholar
Hedrick, HL, Flake, AW, Crombleholme, TM, et al. The ex utero intrapartum therapy procedure for high-risk fetal lung lesions. J Pediatr Surg. 2005;40(6):10381043; discussion 44.Google Scholar
Moldenhauer, JS. Ex utero intrapartum therapy. Semin Pediatr Surg. 2013;22(1):4449.Google Scholar
Style, CC, Cass, DL, Verla, MA, et al. Early vs late resection of asymptomatic congenital lung malformations. J Pediatr Surg. 2019;54(1):7074.Google Scholar
Tsai, AY, Liechty, KW, Hedrick, HL, et al. Outcomes after postnatal resection of prenatally diagnosed asymptomatic cystic lung lesions. J Pediatr Surg. 2008;43(3):513517.Google Scholar
Colon, N, Schlegel, C, Pietsch, J, et al. Congenital lung anomalies: can we postpone resection? J Pediatr Surg. 2012;47(1):8792.Google Scholar
Stanton, M. The argument for a non-operative approach to asymptomatic lung lesions. Semin Pediatr Surg. 2015;24(4):183186.Google Scholar

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