RESUMO
PURPOSE: We investigated the relationship between the affected lobe and symptom onset in prenatally diagnosed congenital pulmonary airway malformation (CPAM). METHODS: 53 CPAM patients diagnosed prenatally were reviewed retrospectively by creating 2 groups according to symptom onset. Group Sneo: (symptomatic during the neonatal period; n = 13) and group S > neo: (symptomatic after the neonatal period; n = 40) were compared for type of CPAM, affected lobes, types of symptoms/infections, treatment, duration of follow-up, and histopathology. Requirement for surgery (Sx) was then used to create three subgroups: Sneo + Sx, S > neo + Sx, and Sx-. RESULTS: Some cases had multiple affected lobes. In Sneo, symptoms developed in 55.6%, 50.0%, 0%, 0%, and 36.8% of right upper lobes (RUL), right middle lobes (RML), right lower lobes (RLL), left upper lobes (LUL), and left lower lobes (LLL) diagnosed with CPAM, prenatally. In S > neo, symptoms developed in 0%, 0%, 6.3%, 55.6%, and 33.3% of RUL, RML, RLL, LUL, and LLL diagnosed with CPAM, prenatally. CONCLUSION: In prenatally diagnosed CPAM, RUL and RML lesions are more likely to become symptomatic in neonates, and LUL lesions in infants. Surgery is recommended before the onset of respiratory infections after 1 year of age.
Assuntos
Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico por imagem , Lateralidade Funcional , Pulmão/diagnóstico por imagem , Ultrassonografia Pré-Natal , Idade de Início , Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia , Feminino , Humanos , Lactente , Recém-Nascido , Pulmão/cirurgia , Masculino , Estudos RetrospectivosRESUMO
Three cases with metastasized choriocarcinoma are reported. The basic chemotherapeutic regimen was methotrexate and actinomycin D, combined with cyclophosphamide or vinblastine. Surgery was used in the treatment of both primary and metastatic lesions. The chief indications for hysterectomy arise when chemotherapy has obviously failed. Thoracotomy was performed for a pulmonary metastasis and nephrectomy for a metastasis of the kidney. Craniotomy was performed to control the brain hemorrhage. Aggressive multidrug chemotherapy is considered necessary as the primary treatment for high-risk cases of trophoblastic disease.
