Dayton Children’s Hospital

Lung Masses

What are lung masses?

Fetal lung masses, also known as fetal lung lesions, are a congenital lung defect, which means they are present at birth. They occur when the baby’s lung tissue doesn’t develop normally. The exact cause of fetal lung masses is unknown.

There are two common types of fetal lung masses:

  1. A congenital cystic adenomatoid malformation (CCAM), also known as congenital pulmonary adenomatoid malformation (CPAM), is a benign (non-cancerous) mass of abnormal lung tissue that forms in one lobe of the lung; the mass does not function like normal lung tissue.
  2. A bronchopulmonary sequestration (BPS) is a mass of tissue that develops in the lungs but is not connected to the bronchial airways. Because it is not connected to the airways, it is not able to function as lung tissue.

How are lung masses diagnosed?

Lung masses are often discovered during a routine prenatal ultrasound. It will show up as a bright mass on the ultrasound. Depending on the size and location of the mass, the baby’s heart may also be shifted to one side. Magnetic resonance imaging (MRI) is sometimes used to give doctors a closer look at the mass once it has been detected.

In other cases, lung masses may not be diagnosed until after the baby is born and begins to show symptoms. Common symptoms include:

  • Respiratory distress
  • Shortness of breath
  • Dry cough
  • Multiple respiratory infections

If your baby is showing symptoms of a lung mass, tests may be done to confirm the diagnosis. Tests may include:

  • Chest X-ray
  • Ultrasound
  • CT scan
  • MRI

How are lung masses treated?

The majority of lung masses that are discovered during pregnancy are safely treated after delivery. In rare instances the lung mass may obstruct blood flow in the chest and cause non-immune hydrops. A large obstructing lung mass may be treated while the baby is still in the womb. One method of treatment is to insert a thoracoamniotic shunt into the lung mass. The shunt drains the fluid from the mass into the amniotic fluid. Draining the fluid while the baby is still in the womb gives the baby’s lungs a better chance of developing normally and may relieve the non-immune hydrops fetalis. If the mass is large and affecting other organs, fetal surgery (surgery on the baby while still in the womb) may be done to remove the mass.

Once the baby is born, the treatment of choice is surgical removal of the lung mass.

How will lung masses affect my baby during and after surgery?

During the surgery, your baby will be given general anesthesia, which means the baby will be sleeping. After surgery, your baby will need to stay in the hospital’s neonatal intensive care unit (NICU) for the first few days and will be connected to several tubes and wires. Most of the tubes and wires will be disconnected before your baby leaves the NICU. However, he or she may spend several days to weeks in the hospital.

Most babies who are surgically treated for fetal lung masses go on to lead healthy lives.