BAPS PapersPrenatal diagnosis and outcome of fetal lung masses
Section snippets
Patient population
After approval from the institutional review board of the Baylor College of Medicine (protocol no. H-20983), the case records and diagnostic imaging studies of all fetuses referred to the Texas Children's Fetal Center between July 1, 2001 and May 30, 2010 with a diagnosis of fetal lung mass were reviewed retrospectively. Fetuses found to have diaphragm hernia (with or without an associated bronchopulmonary sequestration) were excluded. All patients referred to our center underwent comprehensive
Results
During the study period, 82 fetuses (41 male) were evaluated for a confirmed fetal lung mass in the absence of diaphragmatic hernia. Fifty-three fetuses (65%) had left-sided lesions, 28 (34%) had right-sided lesions, and 1 fetus had bilateral lesions identified. The mean age at diagnosis, known for 77 fetuses, was 21.7 ± 4.5 weeks, and the mean age at consultation in our center was 27.1 ± 5.1 weeks of gestation. Seventy-three fetuses had at least 1 fetal MRI performed at 26.1 ± 3.1 weeks of
Discussion
It seems intuitive that the size of the fetal lung mass correlates with outcome. Larger rapidly growing masses may compress the mediastinum and esophagus, leading to impaired fetal swallowing and polyhydramnios and, ultimately, fetal death. This process was elucidated by Rice et al [8] in a sheep model in which balloon tissue expanders were gradually inflated in the thorax of 120-day-old fetal lambs. As the balloon was expanded, these fetal lambs developed signs of hydrops with ascites and
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