Congenital Thoracic Malformations: A Single-Center Retrospective Study From Hong Kong

Area of Science:

• Pediatric Surgery
• Thoracic Surgery
• Developmental Biology

Background:

• Congenital thoracic malformations (CTMs) are developmental lung anomalies, with congenital pulmonary airway malformation (CPAM) being the most common subtype.
• Management strategies for asymptomatic CTMs remain a subject of debate.
• This study reviews CTMs in a Chinese population to inform clinical decision-making.

Purpose of the Study:

• To analyze the clinical course, management options, and outcomes of congenital thoracic malformations (CTMs).
• To provide evidence-based guidance for the future management of CTMs, particularly in asymptomatic cases.

Main Methods:

• Retrospective review of electronic medical records from Tuen Mun Hospital, Hong Kong (2002-2024).
• Inclusion of all cases with computed tomography (CT)-confirmed CTM diagnosis.
• Categorization into antenatally diagnosed (AN) and postnatally diagnosed (PN) groups for comparative analysis.

Main Results:

• A cohort of 45 CTM cases was analyzed (18 AN, 27 PN).
• Most AN cases (61.1%) remained asymptomatic; 48.2% of PN cases were incidental findings.
• Pneumonia was the most frequent complication (33.3% AN, 59.3% PN), with a low incidence of malignancy (one case of lymphoepithelioma-like carcinoma in bronchopulmonary sequestration).

Conclusions:

• CTMs exhibit a relatively indolent and benign clinical course.
• A conservative management approach, including delayed surgical intervention, is a viable alternative for asymptomatic CTMs.
• Findings support individualized management strategies based on clinical presentation and diagnosis.