Congenital Pulmonary Airway Malformation (CPAM)
Also known as: CCAM (Congenital Cystic Adenomatoid Malformation).
What is congenital cystic adenomatoid malformation?
CPAM is one or more benign (non-cancerous) lumps (masses) or cysts of abnormal lung tissue usually prenatally diagnosed with US during pregnancy. They can range from small to very large in size where they may (in 10% of children) cause significant complications during fetal intrauterine life.
What causes congenital pulmonary airways malformation?
The exact etiology is unknown, but it is secondary to abnormal development of part of the lung tissue which will never function normally.
What are the symptoms of CPAM?
Most infants with CPAM are diagnosed by prenatal maternal ultrasound, and many do not require any intervention. At Nicklaus Children’s Hospital Fetal Care Center, we will be able to assess the lesion based on the US. Often, in addition, we perform state of the art maternal MRI which allows for accurate assessment of the fetal lungs which allows us to predict the severity of the symptoms after birth. Fetal intervention is reserved for severe cases where fetal hydrops (excess fluid around the fetal organs) is present. After birth most lesions are asymptomatic and can be dealt with outside of the newborn period.
What are congenital cystic adenomatoid malformation care options?
Surgical removal of the part of the lung that contains the CPAM considered to be the standard of care by most centers in the United States. In our center at Nicklaus Children’s Hospital we employ the most advanced minimally invasive surgical techniques to remove the affected part of the lung (frequently around 3 to 6 months of age).
After the surgical intervention, the baby will be closely monitored and the duration of hospital stay, usually a couple of days, varies based on the extent of the resection and the surgical approach. Most children have no untoward outcomes and go on to lead normal lives.
The Fetal Care Center Team at Nicklaus Children's Hospital
The Fetal Care Center at Nicklaus Children’s is devoted to the care of infants prediagnosed with medical needs in utero that will require intervention at birth.
The Nicklaus Children's multidisciplinary team of pediatric subspecialists including pediatric surgeons, ob/gyns, neonatologists, cardiologists and other specialists collaborate with prenatal care providers in the community and beyond to provide families comprehensive, coordinated care and support from prenatal testing to delivery, postnatal care and the transition to infant care.
Reviewed by: Fuad Alkhoury, MD
This page was last updated on: December 18, 2020 05:02 PM
Patient Success Stories
After surviving a high-risk pregnancy with a set of twins, the Strombom’s were faced with yet another complication. Their third child, an unborn baby named Charlie, was diagnosed with a congenital pulmonary airway malformation (CPAM) and underwent two in utero interventions to allow for a full and healthy gestation period. Once delivered, the LifeFlight team from Nicklaus Children’s Hospital was on stand-by to transport Charlie from West Palm Beach to Miami.
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A magnetic resonance image of a fetus provides detailed images of the unborn baby without causing any harm to either the expectant mother or her baby. MRI offers significantly more detailed images than fetal ultrasound exams.