Laser therapy for type III fetal congenital cystic adenomatoid malformation

Abstract

Congenital cystic adenomatoid malformation (CCAM) is a rare developmental anomaly of the fetal lung that can lead to severe respiratory distress in the neonatal period. Type III CCAM, characterized by solid, microcystic lesions, often poses diagnostic and therapeutic challenges, especially in progressive cases. We report a rare case of antenatal laser therapy used to treat a fetus diagnosed with type III CCAM. Despite two cycles of corticosteroid therapy, the lesion showed no significant regression, leading to the decision to perform ultrasound-guided intrauterine laser ablation. The procedure resulted in a reduction in lesion size, normalization of the fetal cardiac axis, and a favorable perinatal outcome, with the newborn discharged 5 days after birth in stable condition. This case highlights the potential role of fetal laser therapy as a less invasive and effective alternative to surgical excision for selected cases of progressive type III CCAM. Further studies are needed to validate the safety, efficacy, and long-term outcomes of this approach.