Congenital Lung Lesions (CPAM)
Also covered as: CPAM · congenital pulmonary airway malformation · bronchial atresia · hydrops · CPAM (congenital pulmonary airway malformation) · bronchopulmonary sequestration · pleuropulmonary blastoma · bronchogenic cyst
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Answers come only from this collection's statement ledger and cite the exact moment · not medical advice
Content of this collection
Foundations
2 items
Neonatal Lung Lesions with Dr. Steven Rothenberg
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Dr. Steven Rothenberg discusses Newborn Lung Lesions with Dr Todd Ponsky. Edited by Ian C. Glenn, MD Nicholas E. Bruns, MD
podcast · 66:58 · Jan 2019
Wilms Tumor: Audio Chapter
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An interactive discussion about Wilms tumor between Todd Ponsky, MD, Avraham Schlager, and Peter Ehrlich, MD.Dr. Peter Ehrlich is a professor of pediatrics surgery at the University of Michigan C.S. Mott Children’s Hospital who is also a vi
podcast · 64:03 · Jan 2021
Diagnosis & Workup
1 item
Prenatal Management of CPAMs: Lung Lesions
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Dr. Alan Flake discusses prenatal management of congenital pulmonary airway malformations (CPAMs). It includes two videos of examples of fetal surgery.
video · 18:16 · Jan 2019
Acute Management
4 items
Fetal Interventions Part II: Lung Lesions
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Dr. Alan Flake leads a discussion in fetal interventions for prenatally-diagnosed lung lesions.
video · 16:30 · Jan 2019
Open Fetal Surgery Overview: Fetal Surgery 2012
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Dr. Flake, attending surgeon and director of the General Surgery Fellowship Program at The Children's Hospital of Philadelphia,presents a brief overview of open fetal surgery. Topics discussed include the prenatal diagnosis of an abnormal f
video · 37:55 · Jan 2019
Fetal Interventions Part I: Lung Lesions
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Dr. Alan Flake leads a discussion in fetal interventions for prenatally-diagnosed lung lesions.
video · 14:27 · Jan 2019
Lung Lesions: Fetal Interventions Parts I+II
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Dr. Alan Flake leads a discussion in fetal interventions for prenatally-diagnosed lung lesions.
video · 30:56 · Jan 2019
Surgical Management
10 items
Postnatal Management of Lung Lesions Part III: Pediatric Thoracic Surgery...
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Course directors Drs Alan Flake, Steve Rothenberg and Todd Ponsky, along with additional faculty including Drs Jean Martin Laberge, Ramesh Santhanakrishnan, Giovanna Riccipetitoni, Mark Wulkan, Alexander Razumovskiy, Starla Martinez, Marcel
video · 27:56 · Sep 2018
Postnatal Management of Lung Lesions Part II: Pediatric Thoracic Surgery...
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Course directors Drs Alan Flake, Steve Rothenberg and Todd Ponsky, along with additional faculty including Drs Jean Martin Laberge, Ramesh Santhanakrishnan, Giovanna Riccipetitoni, Mark Wulkan, Alexander Razumovskiy, Starla Martinez, Marcel
video · 25:07 · Sep 2018
Postnatal Management of Lung Lesions Part I: Pediatric Thoracic Surgery Part...
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Course directors Drs Alan Flake, Steve Rothenberg and Todd Ponsky, along with additional faculty including Drs Jean Martin Laberge, Ramesh Santhanakrishnan, Giovanna Riccipetitoni, Mark Wulkan, Alexander Razumovskiy, Starla Martinez, Marcel
video · 31:07 · Sep 2018
Technique: Blinded Left Upper Lobectomy
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Dr. Steven Rothenberg performs a thoracoscopic blinded left upper lobectomy for a prenatally-diagnosed CPAM.
video · 4:28 · Jan 2019
Thoracoscopic Right Lower Lobe Cystic Lesion Excision: Update Course 2014
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Dr. Steve Rothenberg, Chief of Pediatric Surgery at Rocky Mountain Hospital for Children, Denver, Colorado, presents the topic of congenital cystic lung lesions. Topics discussed include asymptomatic congenital lung lesions, thoracoscopic l
video · 11:24 · Jan 2019
Thoracoscopic Upper Lobectomies for Symptomatic Congenital Pulmonary Airway...
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This video appears in a new pediatric surgery textbook, Clinical Pediatric Surgery: A Case-Based Interactive Approach," by Dr. Sherif Emil. The book is an innovative educational resource that focuses on judgment and decision-making in pedia
video · 5:58 · Feb 2020
Thoracoscopic Left Lower Lobectomy for Congenital Pulmonary Airway Malformation
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This video appears in a new pediatric surgery textbook, Clinical Pediatric Surgery: A Case-Based Interactive Approach," by Dr. Sherif Emil. The book is an innovative educational resource that focuses on judgment and decision-making in pedia
video · 9:59 · Feb 2020
Thoracoscopic Left Lower Lobectomy for Congenital Pulmonary Airway Malformation
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This video appears in a new pediatric surgery textbook, Clinical Pediatric Surgery: A Case-Based Interactive Approach," by Dr. Sherif Emil. The book is an innovative educational resource that focuses on judgment and decision-making in pedia
video · 9:59 · Feb 2020
Thoracoscopic Upper Lobectomies for Symptomatic Congenital Pulmonary Airway...
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This video appears in a new pediatric surgery textbook, Clinical Pediatric Surgery: A Case-Based Interactive Approach," by Dr. Sherif Emil. The book is an innovative educational resource that focuses on judgment and decision-making in pedia
video · 5:58 · Feb 2020
Neonatal Lung Lesions with Dr. Steven Rothenberg
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Dr. Steven Rothenberg discusses Newborn Lung Lesions with Dr Todd Ponsky. Edited by Ian C. Glenn, MD & Nicholas E. Bruns, MDPrenatal evaluationPatients with prenatal diagnosis of cystic lung lesions are referred for prenatal evaluation and
podcast · 66:58 · Dec 2020
Complications
1 item
Complications and Beyond
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This clip from the 2020 Pediatric Surgery Update Course features an entertaining debate from the full panel surrounding unique and complicated cases presented by Jason Fraser, MD; and Miguel Guelfand, MD.
Highlighted Topics Include:
- M
video · 66:36 · Sep 2020
Evidence & Research
9 items
Management of Asymptomatic Lung Lesions: Pediatric Thoracic Surgery Part...
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Course directors Drs Alan Flake, Steve Rothenberg and Todd Ponsky, along with additional faculty including Drs Jean Martin Laberge, Ramesh Santhanakrishnan, Giovanna Riccipetitoni, Mark Wulkan, Alexander Razumovskiy, Starla Martinez, Marcel
video · 20:11 · Jan 2019
Should We Resect Asymptomatic CPAM Flake vs Langer
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Great Debate from 2017! Watch Alan Flake and Steve Rothenberg debate Jack Langer and Jean Matin Laberge on wether or not asymptomatic CPAM's need to be resected. Originally aired March 23, 2017
video · 14:03 · May 2019
Journal of Pediatric Surgery Article Review: November 2021
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We're back with the November issue of JPS article highlights. This time we're talking to Dr. Pablo Laje and authors Dr. Frederick Rescorla and Dr. Niloufar Hafezi.Hosts: Ellen Encisco & Rod GerardoArticles: Rubalcava NS, Overman RE, Hirschl
podcast · 11:48 · Jan 2022
Case Based Journal Review - CPAM in 2022
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Dr. José Campos is back, this time helping us review some of the latest literature on the diagnosis and management of CPAM in children. In this podcast, we're reviewing a typical case with Dr. Todd Ponsky and incorporating literature from t
podcast · 12:23 · Apr 2022
Update Course 2022 - APSA PDC UPDATES - Mary Edwards, Paul Jeziorczak, Craig Lillehei, and Charles Snyder,
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In this session, members of the APSA Professional Development Committee (PDC) discussed the latest top articles and practice updates. We were joined by Drs. Mary Edwards, Paul Jeziorczak, Craig Lillehei, and Charles Snyder.
Topics discus
video · 64:30 · Sep 2022
Update Course Rewind: Congenital Lung Lesions 2022
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We are back with another Update Course Rewind video! This time we are presenting you "Congenital Lung Lesions" with Dr. Charles Snyder from APSA Professional Development Committee.
Host: Brittany Levy
Register for #UpdateCourse2023 (A
video · 4:33 · Aug 2023
Clinical Symptoms Affect Treatment and Prognosis in Pediatric Patients with Congenital Pulmonary Airway Malformation
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New article you should know by Dr. Cecilia Gigena
"Clinical Symptoms Affect Treatment and Prognosis in Pediatric Patients with Congenital Pulmonary Airway Malformation: A Propensity Score Matching Retrospective Cohort Study"
Authors: Guow
video · 0:55 · Dec 2023
Journal of Pediatric Surgery Article Review: October 2023
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We’re featuring Journal of Pediatric surgery articles to bring you some of the latest news!
This week we are discussing 3 articles from October 2023 issue, with editor Dr. Pablo Laje and authors Thomas Wyllie, and Drs. Mallinath Chakribo
podcast · 12:59 · Apr 2024
Quick Literature Updates Episode 18
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We’re back with eighteenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most int
video · 4:21 · Mar 2025
Case-Based Learning
3 items
Panel Discussion: Pediatric Thoracic Surgery Part 1-Lung Lesions 2012
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The internationalfaculty debate and discuss management of difficult cases, includinglower lobe cystic lesion, spontaneous pneumothorax and unilateral bleb disease, and right pulmonary cyst.
video · 61:56 · Jan 2019
Difficult Cases of Lung Lesions: Pediatric Thoracic Surgery Part 1-Lung...
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During this session, the faculty discuss a patient with right pulmonary cyst, reviewingthe thoracoscopic to thoracotomy approach, and discuss varying ways of managing this particular case.
video · 21:56 · Jan 2019
Spontaneous Pneumothorax: Lung Lesions
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Dr. Mark McCollum leads a discussion in the management of spontaneous pneumothorax, including the type of anesthesia for chest tube insertion, indications for CT scans, number of ports in VATS, recurrence of bilateral blebs, and different t
video · 22:21 · Jan 2019
In-Depth Reviews
2 items
Congenital Cystic Lung Lesions: Update Course 2014
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Dr. Steve Rothenberg, Chief of Pediatric Surgery at Rocky Mountain Hospital for Children, Denver, Colorado, presents the topic of congenital cystic lung lesions. His discussion includes various case presentations and comprehensive panel dis
video · 24:39 · Nov 2018
The Full Story on CPAMs
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Here we cover Congenital Pulmonary Airway Malformations (CPAMs) through a story with the help of Dr. Todd Ponsky, Dr. Pam Choi, Dr. Beth Rymeski, Dr. Jacob Langer, and Dr. Steven Rothenberg. Hosts: Ellen Encisco & Rod GerardoChapter 1: Pren
podcast · 56:08 · Sep 2021
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Every statement below comes from the recorded discussions, with its speaker and moment.
Update Course Rewind: Congenital Lung Lesions 2022
The incidence of congenital lung lesions has increased over the past decades because more prenatal screening has been occurring worldwide
epidemiological0:15 ↗
Congenital lung lesions can often lead to malignancy or recurrent infections, both of which may require surgical workup and management
clinical0:23 ↗
In 2021, the Midwest Pediatric Surgery Consortium reviewed 521 primary lung lesions from 11 children's hospitals to identify specific risk factors associated with malignancy
epidemiological1:07 ↗
In the Midwest Pediatric Surgery Consortium series, no prenatally diagnosed lesions were malignant
epidemiological1:20 ↗
Roughly 10% of postnatally diagnosed congenital lung lesions were malignant
epidemiologicalChuck Snyder1:24 ↗
About half of the malignant lesions were associated with the DICER1 mutation
clinicalChuck Snyder1:24 ↗
There was no malignant lesion that had a systemic feeding vessel
clinicalChuck Snyder1:32 ↗
CT scan had poor sensitivity and specificity for malignancy
clinical1:36 ↗
Suspicion for malignancy by a CT scan and bilateral disease were predictive of malignancy
clinical1:40 ↗
In a series of approximately 400 cystic lesions, there was not a single patient who had antenatal diagnosis who was found to have a pleuropulmonary blastoma (PPB)
epidemiological1:48 ↗
If you have prenatal diagnosis, the chances of being PPB are close to 0
epidemiological1:59 ↗
For asymptomatic prenatally diagnosed lesions, the malignancy risk is not zero
clinical2:21 ↗
Many prenatally suspected lesions turn out to be nothing after birth, either not present or representing a mucus plug that has resolved
clinical2:37 ↗
CPAM becomes a general bucket for these lesions in the fetal world
clinical2:52 ↗
As the ability to identify specific lesions gets better with technological advances, management needs to change
opinion2:56 ↗
Children aged 4-9 years old with recurrent pneumonias from congenital lung lesions present a surgical challenge
clinical3:04 ↗
The chances of successful thoracoscopic resection are much lower in children aged 4-9 years with recurrent pneumonias than in the perinatal period or first year of life
clinical3:13 ↗
The primary concern for resection is preventing recurrent pneumonias and bronchiectasis rather than cancer
opinion3:28 ↗
The range of congenital lung anomalies varies from trivial little cysts to multilobar lesions that would require pneumonectomy
clinical3:35 ↗
Management must be tailored to the actual pathology of each individual lesion
opinion3:50 ↗
Reasons to resect congenital lung lesions include infection and risk of malignancy, with malignancy risk being a more minor reason for most surgeons
opinion4:12 ↗
Panel Discussion: Pediatric Thoracic Surgery Part 1-Lung Lesions 2012
Taking a lobectomy from an infant gives normal pulmonary functions when older
clinicalAlan9:04 ↗
The risk of leaving CPAM disease behind by segmentectomy is relatively high
clinicalAlan9:21 ↗
Segmentectomy of segment 6 and segment 10 is very difficult to perform thoracoscopically
clinicalYama9:51 ↗
If you do 100 segmentectomy cases, the likelihood of missing disease is significantly higher and complications are higher than lobectomy
clinicalAlan11:49 ↗
Patients that undergo simple chest tube placement for symptomatic pneumothorax have upwards of 50% recurrence rate
epidemiologicalAlan22:56 ↗
Second recurrence of pneumothorax occurs in about 75% of cases
epidemiologicalAlan23:36 ↗
A recent study from Saint Peter in Kansas City found CT scan was very poor at defining bleb disease compared to subsequent thoracoscopy
clinicalAlan28:46 ↗
Almost all kids with spontaneous pneumothorax have some degree of bleb disease whether defined early or not
clinicalAlan28:55 ↗
Bleb disease doesn't necessarily mean recurrence
clinicalAlan29:01 ↗