Hybrid congenital lung malformation: case report

Zeidy P. Ramírez-López, Departamento de Pediatría, Hospital Roosevelt, Guatemala, Guatemala
Karla Ma. Oliva-Adrover, Departamento de Pediatría, Hospital Roosevelt, Guatemala, Guatemala
Rocío A. Godínez-Cabrera, Departamento de Pediatría, Hospital Roosevelt, Guatemala, Guatemala
Eify D. Roca-Girón, Departamento de Pediatría, Servicio de Intensivo Pediátrico, Hospital Roosevelt, Guatemala, Guatemala
Juan P. Zaldaña-Figueroa, Departamento de Pediatría, Servicio de Intensivo Pediátrico, Hospital Roosevelt, Guatemala, Guatemala
Natalia I. Ybarra-García, Departamento de Cirugía Pediátrica, Hospital Roosevelt, Guatemala, Guatemala
Javier Bolaños-Bendfeldt, Departamento de Cirugía Pediátrica, Hospital Roosevelt, Guatemala, Guatemala

Background: A rare cause of morbidity in the newborn is congenital malformations of the respiratory tract. Many of them can have a common origin, which is why there is the possibility of presenting them together, known as hybrid pulmonary malformation. The joint appearance of pulmonary sequestration and cystic adenomatoid malformation has been described in very few cases, approximately 40-60 patients since the first case reported in 1949. Pulmonary sequestration is defined as ectopic nonfunctioning pulmonary cystic tissue, with its own arterial vascularization of systemic origin. It is a rare congenital disease, with variable clinical presentation, which can be intralobar or extralobar, and may be accompanied by other malfor- mations as in the case of congenital adenomatous disease. In most cases the treatment is surgical, consisting of lobar re-sections through video thoracoscopy. Clinical case: Seven-day-old patient who at birth begins with severe respiratory difficulty requiring invasive mechanical ventilation. Left pleural effusion and pneumothorax are identified, so a thoracostomy tube is placed, however, it does not completely resolve, the clinical suspicion of congenital pulmonary malformation arises, which is confirmed by means of pulmonary computed tomography and pulmonary angiography, which shows accessory vessel of aortic origin for which surgical treatment is performed. Conclusions: Early resection may be beneficial for lung growth.

Keywords: Congenital cystic adenomatoid malformations. Pulmonary sequestration. Congenital thoracic malformation.