First‐trimester prenatal diagnosis of a thoracic cystic lesion associated with fetal skin edema

An unusual case of chest cyst diagnosed at the end of the first trimester in a dizygotic twin pregnancy and managed conservatively is reported. Between 11 and 14 weeks of gestation, ultrasound revealed a relatively large echopoor lung cyst occupying the left side of the chest, displacing the mediastinum and the heart. This was associated with increased nuchal translucency thickness and generalized skin edema. Subsequent sonograms showed complete resolution of the cyst together with the skin edema. The fetuses were delivered at term and had an uncomplicated postnatal outcome. This case emphasizes the role of reduced venous return as a cause of early fetal hydrops. Diagnosis and follow‐up of a congenital lung cyst from the end of the first trimester should enable early intervention to be made.

[1]  P. Hélardot,et al.  Congenital adenomatoid disease of the lung: prenatal diagnosis and perinatal management , 1997, Pediatric Surgery International.

[2]  K. Nicolaides,et al.  Using fetal nuchal translucency to screen for major congenital cardiac defects at 10-14 weeks of gestation: population based cohort study , 1999, BMJ.

[3]  R. Snijders,et al.  Defects and syndromes in chromosomally normal fetuses with increased nuchal translucency thickness at 10–14 weeks of gestation , 1998, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[4]  K. Nicolaides,et al.  Collagen Type VI Gene Expression in the Skin of Trisomy 21 Fetuses , 1998, Obstetrics and gynecology.

[5]  M. Davenport,et al.  Fetal Nuchal Translucency Thickness at 10–14 Weeks' Gestation and Congenital Diaphragmatic Hernia , 1997, Obstetrics and gynecology.

[6]  E. Jauniaux.  Diagnosis and management of early non‐immune hydrops fetalis , 1997, Prenatal diagnosis.

[7]  E. Effmann,et al.  Congenital masses of the lung: Changes in cross‐sectional area during gestation , 1997, Journal of clinical ultrasound : JCU.

[8]  E. Jauniaux,et al.  Outcome of Nonimmune Hydrops Fetalis Diagnosed During the First Half of Pregnancy , 1997, Obstetrics and gynecology.

[9]  K. Nicolaides,et al.  Increased nuchal translucency thickness at l0–14 weeks of gestation as a predictor of severe twin‐to‐twin transfusion syndrome , 1997, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[10]  P. Stafford,et al.  Cystic lung lesions with systemic arterial blood supply: a hybrid of congenital cystic adenomatoid malformation and bronchopulmonary sequestration. , 1997, Journal of pediatric surgery.

[11]  K. Nicolaides,et al.  Abnormalities of the heart and great arteries in chromosomally normal fetuses with increased nuchal translucency thickness at 1l–13 weeks of gestation , 1996, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[12]  K. Nicolaides,et al.  Cardiac Gene Expression of Atrial Natriuretic Peptide and Brain Natriuretic Peptide in Trisomic Fetuses , 1996, Obstetrics and gynecology.

[13]  K. Nicolaides,et al.  First‐trimester ultrasound screening for chromosomal defects , 1996, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[14]  J. Estroff,et al.  Fetal lung masses: prenatal course and outcome. , 1995, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[15]  K. Nicolaides,et al.  First-trimester nuchal translucency and cardiac septal defects in fetuses with trisomy 21. , 1995, American journal of obstetrics and gynecology.

[16]  E. Dykes,et al.  Accuracy of prenatal diagnosis of congenital cystic adenomatoid malformation , 1994, Archives of disease in childhood. Fetal and neonatal edition.

[17]  K. Nicolaides,et al.  Cystic Adenomatoid malformation of the lung: Prenatal diagnosis and outcome , 1994, Prenatal diagnosis.

[18]  M. Hod,et al.  Antenatal ultrasound diagnosis of congenital cystic adenomatoid malformation of the lung: Spontaneous resolution in utero , 1993, Journal of clinical ultrasound : JCU.

[19]  P. Russo,et al.  Congenital adenomatoid malformation of the lung: current management and prognosis. , 1991, Journal of pediatric surgery.

[20]  A. Bowen,et al.  Bronchopulmonary and neurenteric forms of foregut anomalies. Imaging for diagnosis and management. , 1991, Radiologic clinics of North America.

[21]  G. Mendelsohn,et al.  Congenital cystic adenomatoid malformation of the lung. , 1978, Archives of pathology & laboratory medicine.

[22]  R. Drake,et al.  Congenital cystic adenomatoid malformation of the lung. Classification and morphologic spectrum. , 1977, Human pathology.

[23]  S. G. Driscoll.  Hydrops fetalis. , 1966, The New England journal of medicine.