Navigating the Challenges of Neonatal Type 2 CPAM: A Case Study of Successful Pneumonectomy and Intensive Care

Document Type : Case Report

Authors

1 Department of Pediatrics, Faculty of Medicine, Padjadjaran University, Dr. Hasan Sadikin General Hospital, Bandung, West Java 40161, Indonesia

2 Department of Pathology Anatomy, Padjadjaran University, Dr. Hasan Sadikin General Hospital, Bandung, West Java 40161,

10.22038/ijn.2026.87641.2687

Abstract

Background: Congenital Pulmonary Airway Malformation (CPAM) is a rare problem in the development of the fetal tracheobronchial tree. If it is not treated properly, it can cause serious illness and even death. This report documents and emphasizes the challenges associated with postnatal CPAM diagnosis, the risks of significant surgical intervention, and the importance of meticulous clinical management to achieve the best possible patient outcomes.
Case Report: This case report details the condition of a 14-day-old male neonate diagnosed with Type II CPAM, a collapsed area in his left lung, pneumonia, ASD, and VSD. The patient underwent surgery to remove his left lung on the 19th day after birth (5 days after admission). Chest tubes were placed after the operation. Although he experienced some complications after surgery, he gradually improved and was discharged 42 days after the surgery.
Conclusion: Early surgery for symptomatic CPAM can lead to good outcomes, even in the presence of serious complications. To achieve the best results, it is important to have a multidisciplinary team, robust infection control, and long-term follow-up, especially in places with limited resources.
 

Keywords

References

  1. Dias R. Congenital pulmonary airway malformation. Anästh Intensivmed 2022;63:S15–S22.
  2. Stocker JT, Madewell JE, Drake RM. Congenital cystic adenomatoid malformation of the lung. Classification and morphologic spectrum. Hum 1977;8(2):155-171.
  3. Bush A, Harcout J, Hewitt RJ, Nicholson AG, Wilmott RW, Deterding R, et al. Kendig’s disorders of the respiratory tract in children. Congenital lung malformations. 2019:2793-3011.
  4. Chowdhury MM, Chakraborty S. Imaging of congenital lung malformations. Semin Pediatr Surg 2015;24(4):168–175.
  5. Vohra WI, Shakir M, Dhillo RA, Irfan O, Mirza A.. Multi-disciplinary management of a rare case of a complete lung congenital pulmonary airway malformation in a newborn from a developing country. Int J Pulm Res Sci 2022;6:555683.
  6. Mehta PA, Sharma G. Congenital pulmonary airway malformation. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi. nlm.nih.gov/books/NBK551664/
  7. Finder JD, Michelson P. Congenital Disorders of the Lung. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, editors. Nelson Textbook of Pediatrics. 20th ed. Philadelphia: Elsevier Saunders; 2016;2057–2059.
  8. Lezmi G, Verkarre V, Khen-Dunlop N, Vibhushan S, Hadchouel A, Rambaud C, et al. FGF10 Signaling differences between type I pleuropulmonary blastoma and congenital cystic adenomatoid malformation. Orphanet J Rare Dis. 2013;8:130.
  9. David M, Lamas-Pinheiro R, Henriques-Coelho T. Prenatal and postnatal management of congenital pulmonary airway malformation. Neonatology. 2016;110(2):101-115.
  10. Hsu JS, Zhang R, Yeung F, Tang CSM, Wong JKL, So MT, et al. Cancer gene mutations in congenital pulmonary airway malformation patients. ERJ Open Res. 2019;5(1):00196-2018.
  11. Ch'in KY, Tang MY. Congenital adenomatoid malformation of one lobe of a lung with general anasarca. Arch Pathol (Chic). 1949;48(3):221-229.
  12. Ribet M, Pruvot FR, Dubos JP, Remy J, Sault MC, Gosselin B, et al. Congenital cystic adenomatoid malformation of the lung. Eur J Cardiothorac Surg. 1990;4(8):403-405.
  13. Stocker JT. Congenital and developmental diseases. In: Dail DH, Hammar SP, eds. Pulmonary Pathology, 2nd ed. New York: Springer-Verlag; 1994:174–180.
  14. Chiluveru SA, Dave NM, Dias RJ, Garasia MB. Congenital pulmonary airway malformation with atrial septal defect and pulmonary hypertension for lobectomy-anesthetic considerations. Ann Card Anaesth. 2016;19(2):372-374.
  15. Delestrain C, Khen-Dunlop N, Hadchouel A, Cros P, Ducoin H, Fayon M, et al. Respiratory morbidity in infants born with a congenital lung malformation. Pediatrics. 2017;139(3):e20162988.
  16. Lima M, D’Antonio S, Di Salvo N, Maffi M, Libri M, Gargano T, et al. Is thoracoscopic lung-sparing surgery in treatment of congenital pulmonary airway malformation feasible? J Ped Endos Surg. 2019;1(1):7-14.
  17. Giwangkencana G, Andriyanto L, Zulfariansyah A, Lestari AN. One-lung ventilation techniques in infants and small children. J Ped Surg Case Rep 2022;82:102314.
  18. Tognon C, Meneghini L, Fascetti LF, Gamba PG. The different approaches of single-lung ventilation in infants with pulmonary malformation. Int J Pediatr Res 2018;4(1): 1–6.
  19. Kapralik J, Wayne C, Chan E, Nasr A. Surgical versus conservative management of congenital pulmonary airway malformation in children: A systematic review and meta-analysis. J Pediatr Surg. 2016;51(3):508-512.
  20. Morini F, Zani A, Conforti A, van Heurn E, Eaton S, Puri P, et al. Current management of congenital pulmonary airway malformations: A "European Pediatric Surgeons' Association" Survey. Eur J Pediatr Surg. 2018;28(1):1-5. Erratum in: Eur J Pediatr Surg. 2018;28(1):e1.
  21. Cook J, Chitty LS, De Coppi P, Ashworth M, Wallis C. The natural history of prenatally diagnosed congenital cystic lung lesions: long-term follow-up of 119 cases. Arch Dis Child. 2017;102(9):798-803.
  22. Robinson A, Romao R, Mills J, Davies DA. Decision-making criteria for observational management of congenital pulmonary airway malformations (CPAMs). J Pediatr Surg. 2018;53(5):1006-1009.
  23. Kanafani ZA, Kanj SS. Acinetobacter infection: Treatment and prevention. UpToDate Dec 2023. Available from: https://www.uptodate.com/ contents/acinetobacter-infection-treatment-and-prevention.
  24. Qasemi A, Bayat Z, Akbari N, Babazadeh D. Bacterial resistance of acinetobacter baumannii: A global concern. Res Biotechnol Environ Sci. 2022;1(2):
    36-42.
  25. Rolston KV, Messer M. The in-vitro susceptibility of Alcaligenes denitrificans subsp. xylosoxidans to 40 antimicrobial agents. J Antimicrob Chemother. 1990;26(6):857-860.
  26. Dar SA, Sameen D, Nazir M, Wani WA, Charoo BA. Rare case of neonatal sepsis by Achromonas denitrificans. J Clin Case Rep. 2018;8(1198):2.
  27. Tran C, Bennett MV, Gould JB, Lee HC, Lanzieri TM. Cytomegalovirus infection among infants in neonatal intensive care units, California, 2005–2016. Am J Perinatol 2020;37(2):146–150.
  28. Paes B, Kim D, Saleem M, Wong S, Mitchell I, Lanctot KL; and the CARESS investigators. Respiratory syncytial virus prophylaxis in infants with congenital airway anomalies compared to standard indications and complex medical disorders. Eur J Pediatr. 2019;178(3):377–385.

 

 

 

Iranian Journal of Neonatology
Volume 17, Issue 2
April 2026
Pages 50-58

Files

Share

How to cite

Statistics