Antenatally diagnosed severe congenital pulmonary airway malformation requiring life-saving lobectomy in the early neonatal period: A case report

Abstract

Congenital pulmonary airway malformation (CPAM) ranges from asymptomatic lesions to life-threatening neonatal presentations. Large lesions can lead to severe respiratory failure requiring urgent intervention. We report an early neonatal lobectomy that was indicated for a symptomatic newborn and we present the perioperative challenges. We describe a case of a male neonate conceived via in vitro fertilization (IVF) and born at term. He had an antenatal diagnosis of large right-sided CPAM. Immediately after birth, he developed severe respiratory distress requiring intubation and mechanical ventilation. Refractory hypercapnia prompted urgent surgical intervention. On day 3 of life, a right lower lobectomy was performed. Postoperative complications included persistent pulmonary hypertension and transient neonatal seizures. Extubation was achieved on postoperative day 11, followed by gradual weaning to room air. This case illustrated the successful management of a large antenatally diagnosed CPAM with immediate postnatal decompensation requiring early lobectomy, emphasizing that success relies on accurate prenatal assessment and timely surgical decision-making.