Cystic Adenomatoid Malformation Follow-up

Updated: Jan 08, 2021
  • Author: Anne E Stone, MD; Chief Editor: Denise Serebrisky, MD  more...
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Follow-up

Further Outpatient Care

Generally, following resection of the CCAM, anticipate full recovery.

Regular follow-up in patients who present after adolescence may be necessary in order to detect the presence of an associated malignancy. [18, 19]

In patients who underwent fetal surgery or postnatal resection of CCAM, no clinical evidence of respiratory problems is anticipated; however, a small study has shown that a slight reduction in lung volumes occurred in children who had CCAM postnatally resected. [7, 34]  A longitudinal study found that children with congenital lung malformations, particularly those who required surgery as infants, may be at risk for reduced lung function and exercise tolerance. [35]

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Further Inpatient Care

Respiratory support may be required before and after resection of the congenital cystic adenomatoid malformation (CCAM).

Complications arising as a result of the surgery must be treated (eg, bleeding, infection, analgesia).

Antibiotics are necessary in cases with recurrent pneumonia. Otherwise, no medications are specifically indicated for therapy of CCAM.

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Transfer

Transfer is indicated in cases of CCAM with hydrops to a facility with expertise in fetal surgery. Deliver the baby in a level III NICU.

If the infant is delivered in a facility unskilled in the management of critically ill neonates or in cases of CCAM undiagnosed in the antenatal period, transfer these infants to a facility with expertise in neonatology and neonatal surgery. Additionally, the receiving institution should have the capability to offer ECMO. [4]

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Deterrence/Prevention

As with all children, particularly those with a history of pulmonary problems, avoid smoking by and around the child.

In the absence of any known risk factors for the development of CCAM, no advice regarding prepregnancy preventive measures can be provided.

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