Successfully treated congenital cystic adenomatoid malformation by open fetal surgery A care-compliant case report of a 5-year follow-up and review of the literature

Background: Congenital cystic adenomatoid malformation (CCAM) is a rare hamartomatous cystic lesion. Open fetal surgery currently provides a potential therapeutic option for management of a fetus with CCAM diagnosis. CaseSummary: A 22-year-old G2P0 woman presented at 2117 weeks' gestation for evaluation of a fetus with a left lung lesion and diagnosed as CCAM at 2837 weeks' gestation. Open fetal surgery was performed to resection the lesion at 2927 weeks' gestation under deep maternal general anesthesia. The mother presented at 357 weeks after open fetal surgery with preterm premature rupture of membranes (PPROM) and underwent cesarean delivery at 3267 weeks' gestation. A vigorous woman infant of 1955g, with good Apgar score, was delivered. At 1 month, 4 years, and present, 5 years after birth, she has continued to do well without any obvious deficit and both respiration and circulation were well maintained. Conclusion: We present one case of CCAM which was cured by open fetal surgery and continued to do well at follow-up of 5 years. The success of treatment provided preliminary experience for further carrying out such interventions in China.