Fetal thoraco-amniotic shunting for large macrocystic congenital cystic adenomatoid malformations (CCAM) of the lung

Purpose: To evaluate fetal thoraco-amniotic shunting for isolated large macrocystic cystic adenomatoid malformations (CCAM) of the lung. Methods: Retrospective study of 12 fetuses with macrocystic CCAM's, who underwent thoraco-amniotic shunting. Results: Shunts were inserted at 24.6 (17 – 32) wks. All 12 fetuses had very large macrocystic CCAMs with marked mediastinal shift. Seven fetuses were hydropic, and 5 lesions were either very large or increasing rapidly; 4 had polyhydramnios. Shunting one cyst always decompressed the entire lesion and hydrops and/or hydramnios resolved. In one case very severe hydrops wa…