Secuestro pulmonar extralobar asintomático y la importancia del diagnóstico y tratamiento perinatal: El manejo expectante no es una opción terapéutica

Abstract

Introduction: Prenatal ultrasonography currently represents presentation form of bronchopulmonary malformations. To 90% manifest in neonates with obvious radiological abnormalities and symptomatic progression where surgical resection is clearly indicated. In < 4% causing mass effect with mediastinal shift, hydrops and fetal death and other extreme behave «asymptomatic» with apparent involution and its management has been controversial: early elective resection or radiologic expectant management to document the regression or development complications. It analyzes the literature about the controversy: operate or not to operate. Description of cases: Three fetuses with prenatal diagnosis of intrathoracic solid mass, asymptomatic newborns: one with hydrothorax and other without apparent prenatal involution both with abnormal irrigation compatible with extralobar sequestration, the third with a paracardiac mass where imaging studies did not diagnostic a extralobar sequestration of ectopic location and synchronous with cystic adenomatoid malformation, only transoperative and pathological fi nd- ings confi rmed the diagnosis. Discussion: In asymptomatic patients all bronchopulmonary malformations could be diagnosed and surgically resected for unrecognized their natural history and the low rate of natural regression, radiological proposals are not effective for monitoring.