Congenital lung abnormality in a 1-yr old.

An asymptomatic 8-week-old male infant was referred for assessment. A prenatal ultrasound had been suggestive of a congenital cystic adenomatoid malformation (CCAM). Following delivery, he had a plain chest radiograph (fig. 1) and went on to have a computed tomography (CT) scan of the thorax (fig. 2), which showed an extrapulmonary mass close to the vertebral column. He proceeded to have magnetic resonance imaging of the thorax to look for intraspinal extension. The appearances were not anticipated, in that the lesion appeared to be intrapulmonary with no extension into the mediastinum, spinal canal or chest wall. The diaphragm was reported as being intact and separating the lesion from the abdominal cavity. There were no abnormal vessels reported. These features were in keeping with an intrapulmonary cystic lesion and the infant was referred for a surgical opinion. As the infant remained well, surgery was deferred until the child was 1-yr old. A routine pre-operative CT scan (fig. 3) was performed on the day before the planned surgery followed by a barium swallow (fig. 4). A surgical procedure for what