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Congenital Pulmonary Airway Malformation in an Adult Male Presenting With Hemoptysis
Marcos Valentin1, Radhika Sharma1, Jorge Trabanco2
1Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA.
Insights
Adults rarely develop congenital pulmonary airway malformations (CPAMs), but symptomatic cases require surgical resection for effective treatment and prevention of complications like bleeding.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Medical Case Reports
Background:
- Congenital pulmonary airway malformations (CPAMs) are uncommon in adults, often remaining asymptomatic until later in life.
- Adult CPAM presentation carries risks including infection, hemorrhage, pneumothorax, and potential malignancy.
Observation:
- A case of an adult male presenting with significant hemoptysis due to a CPAM is detailed.
- Diagnostic imaging (CT scan) and bronchoscopy confirmed the lesion's location in the lingula.
Findings:
- The patient underwent successful elective surgical resection of the CPAM via video-assisted thoracoscopic surgery.
- The procedure resulted in no adverse outcomes for the patient.
Implications:
- Surgical resection is recommended as a safe and effective treatment for symptomatic adult CPAMs.
- While interventions like tranexamic acid and embolization manage hemoptysis, they do not replace definitive surgical management due to recurrence risks.
Abstract:
Congenital pulmonary airway malformations (CPAMs) are rarely encountered in the adult population. Although they are typically diagnosed in the prenatal period, some may not cause symptoms and go unnoticed until adulthood. Patients with CPAM are at risk of developing pneumonia, hemorrhage, pneumothorax, and malignancy. There is a paucity of evidence regarding the management and prognostication of adults with CPAM. Patients often need to undergo surgical resection to prevent further episodes of infection, bleeding, or malignant transformation. Here, we present the case of an adult male with a CPAM who presented with frank hemoptysis. Computed tomography scan and bronchoscopy localized the lesion to the lingula. The patient underwent elective surgical resection of the lesion by video-assisted thoracoscopy and did not suffer any adverse outcomes. Surgical resection is generally recommended and appears to be a safe and effective approach to treating patients with symptomatic CPAMs. Inhaled tranexamic acid and bronchial artery embolization are valuable interventions in our armamentarium for managing hemoptysis but should not replace a definite surgical intervention due to the risk of recurrence.
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