UNASSIGNED: Congenital pulmonary airway malformation is a very rare congenital cystic lung disease that presents in 0.004% of all pregnancies and constitutes <25% of all congenital pulmonary anomalies in children. Respiratory distress is a major concern in these patients.
UNASSIGNED: Here in, we report an 8 month old girl presenting with exacerbation of fast breathing of three days duration. Chest X-ray showed hyper lucent right lung with significant shift of mediastinum to the left side, flattening of the diaphragm on the right side and compression of the left lung. Computed tomography scan of the chest revealed multiseptated cystic mass on the right lung measuring 8.9cm by 6.9cm. After receiving treatment for pneumonia, surgical excision of the mass was performed and biopsy showed congenital pulmonary airway malformation type1. The infant died on 40th postoperative day from uncontrolled hospital acquired infection.
UNASSIGNED: When a child has respiratory distress, congenital pulmonary airway malformation could be considered after common pathologies are ruled out. Surgical excision, which is the treatment of choice, is recommended to make a definite diagnosis and exclude hidden malignancies.

Pediatric cystic lung lesions have long been a source of confusion for clinicians, radiologists, and pathologists. They encompass a wide spectrum of entities with variable prognostic implications, including congenital lung malformations, pulmonary neoplasms, and hereditary conditions. As our understanding of the developmental and genetic origins of these conditions has evolved, revised nomenclature and classifications have emerged in an attempt to bring clarity to the origin of these lesions and guide clinical management. This review discusses cystic lung lesions and the current understanding of their etiopathogenesis.

OBJECTIVE: Thoracoscopic surgery has been increasingly utilized in treating pediatric congenital lung malformations (CLM). Comparative studies evaluating 30-day outcomes between thoracoscopic and open resection of CLM are lacking.
METHODS: There were 258 patients identified in pediatric NSQIP with a CLM and pulmonary resection in 2012-2013. Comparisons of patient characteristics and outcomes between surgical approaches were made using standard univariate statistics. In addition, a propensity score match was performed to evaluate outcomes in similar patient cohorts.
RESULTS: One-hundred twelve patients (43.4%) received thoracoscopic resections and 146 patients (56.6%) received open resections. Patients undergoing open resections were more likely to be less than 5 months of age and have a comorbidity/preoperative condition (47.3% vs. 25.0%, p<0.001). The extent of resection was a lobectomy in 84.8% of thoracoscopic and 92.5% of open resection patients. Median operative time was similar between both groups (thoracoscopic 172 vs. open 153.5 minutes). On univariate analysis, thoracoscopic resection was associated with decreased postoperative complications (9.8% vs. 25.3%, p=0.001) and LOS (3 vs. 4 days, p<0.001). However, after adjusting for similar patient and operative characteristics, no significant differences were encountered between techniques.
CONCLUSIONS: Thoracoscopic and open resection provide comparable 30-day outcomes and safety in the management of congenital lung malformations.