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Peer-reviewedCC BYJournal of surgical case reports

Delayed diagnosis of congenital pulmonary airway malformation in an infant: diagnostic challenges and surgical implications.

  • Nour Srewell1
  • Youssef Chouman2
  • Yamama Sharief2
  • Mohammed Baraa Meqdad2
  • Mira Hamzeh Rafea3
  • Omar Alsalama2
  • Bushra Alsahan3
  • Mohammd Abdulkader2
  • Sawssan Ali3
  1. 1Department of Vascular Surgery, Al-Mouwasat University Hospital, Omar Bin Abdul Aziz Street, Mezzeh, Damascus, Syria.
  2. 2Department of Pediatric Surgery, Children University Hospital, Al-Mouwasat Street, Mezzeh, Damascus, Syria.
  3. 3Department of Pediatrics, Children University Hospital, Al-Mouwasat Street, Mezzeh, Damascus, Syria.
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Abstract

Although congenital pulmonary airway malformation (CPAM) is usually diagnosed during prenatal screening, delayed presentation may increase diagnostic uncertainty and operative complexity. We report, to our knowledge, the first case of CPAM diagnosed and surgically managed in Syria in a 4-month-old infant presenting with a 1-month history of dyspnea, fever, and poor feeding in the absence of routine prenatal screening. Initial chest radiography, although technically limited, demonstrated a rounded opacity in the right hemithorax, while non-contrast chest computed tomography (CT) revealed multicystic lesions with a hyperattenuating intralesional component, raising suspicion for secondary infection or pleuropulmonary blastoma (PPB). The patient underwent right upper and middle bilobectomy, and histopathological examination confirmed CPAM and excluded PPB. This case highlights the complementary roles of postnatal CT, surgery, and histopathology in confirming CPAM and excluding PPB, particularly when delayed presentation increases operative complexity.

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Cite

BibTeXRIS
BibTeX
@article{srewell2026delayed,
  title = {{Delayed diagnosis of congenital pulmonary airway malformation in an infant: diagnostic challenges and surgical implications.}},
  author = {Nour Srewell and Youssef Chouman and Yamama Sharief and Mohammed Baraa Meqdad and Mira Hamzeh Rafea and Omar Alsalama and Bushra Alsahan and Mohammd Abdulkader and Sawssan Ali},
  journal = {Journal of surgical case reports},
  year = {2026},
  month = oct,
  doi = {10.1093/jscr/rjag924},
  url = {https://europepmc.org/article/MED/42899236},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Delayed diagnosis of congenital pulmonary airway malformation in an infant: diagnostic challenges and surgical implications.
AU  - Nour Srewell
AU  - Youssef Chouman
AU  - Yamama Sharief
AU  - Mohammed Baraa Meqdad
AU  - Mira Hamzeh Rafea
AU  - Omar Alsalama
AU  - Bushra Alsahan
AU  - Mohammd Abdulkader
AU  - Sawssan Ali
PY  - 2026
DA  - 2026/10/19
JO  - Journal of surgical case reports
DO  - 10.1093/jscr/rjag924
UR  - https://europepmc.org/article/MED/42899236
AB  - Although congenital pulmonary airway malformation (CPAM) is usually diagnosed during prenatal screening, delayed presentation may increase diagnostic uncertainty and operative complexity. We report, to our knowledge, the first case of CPAM diagnosed and surgically managed in Syria in a 4-month-old infant presenting with a 1-month history of dyspnea, fever, and poor feeding in the absence of routine prenatal screening. Initial chest radiography, although technically limited, demonstrated a rounded opacity in the right hemithorax, while non-contrast chest computed tomography (CT) revealed multicystic lesions with a hyperattenuating intralesional component, raising suspicion for secondary infection or pleuropulmonary blastoma (PPB). The patient underwent right upper and middle bilobectomy, and histopathological examination confirmed CPAM and excluded PPB. This case highlights the complementary roles of postnatal CT, surgery, and histopathology in confirming CPAM and excluding PPB, particularly when delayed presentation increases operative complexity.
SN  - 2042-8812
ER  -