PMC3924738_01
(A) Ultrasonography showing a hyperechoic mass of 70 mm with an enclosed cystic lesion of 25 mm in the right lung with massive ascites surrounding the liver. (B) The mass is supplied by the pulmonary artery (arrow), and the heart is severely deviated to the left side of the thoracic cavity. Lt, left; Rt, right.
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F1
The initial ultrasonography revealed a huge hyperechoic and well-defined mass in the right lung, occupying approximately three-quarters of the thoracic volume (Fig. 1A). A cystic lesion of 25 mm in diameter was located centrally within the mass and this mass was supplied by the pulmonary artery (Fig. 1B).
(A) Placement of the abdomino-amniotic shunt (arrow) in situ to eliminate ascites. (B) Ultrasonographic findings at 31+2 weeks of gestation showing the left lung with alleviated mediastinal shifting. (C) Postnatal chest computed tomography showing the right lung with a centrally located congenital cystic adenomatoid malformation (arrow) and the left normal lung. Lt, left; Rt, right.
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F2
After successful shunting, the ascites disappeared (Fig. 2A) and the fetal hydrops was also resolved two weeks following the shunting. Serial ultrasonographs showed an alleviation of the mediastinal shifting, a decrease in mass size, and the appearance of the left lung (Fig. 2B). Chest computed tomography (CT) showed a large solid mass with an internal cystic lesion in the right middle to lower lung, suggestive of CCAM (Fig. 2C).