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2 results

  • Chapter 11 - Lung Masses

  • from Section 3
  • Edited by Olutoyin A. Olutoye
  • Book:
    Anesthesia for Maternal-Fetal Surgery
    Published online:
    19 November 2021
    Print publication:
    11 November 2021, pp 152-167

  • Summary

    Prenatally diagnosed congenital lung malformations represent a wide variety of fetal pulmonary and airway anomalies, some of which may require close monitoring and perinatal follow-up. Historically these masses were only typically seen when they were very large, at which point they were associated with a high incidence of hydrops and a high termination rate; therefore a diagnosis of a fetal lung mass had a guarded prognosis. Widespread use of prenatal ultrasound improved detection of these masses and advances in surgical techniques have allowed for intervention in the fetal period. More recently, a better understanding of fetal physiology and the use of prenatal steroids has reduced the number of fetuses requiring in-utero intervention. When indicated, in-utero treatment requires a multidisciplinary approach with close attention given to the fetal physiology, risk of maternal complications, and unique anesthetic considerations.

  • Chapter 17.2 - Fetal tumors

  • from Section 2 - Fetal disease
  • Edited by Mark D. Kilby, Anthony Johnson, Baylor College of Medicine, Texas, Dick Oepkes
  • Book:
    Fetal Therapy
    Published online:
    05 February 2013
    Print publication:
    13 December 2012, pp 329-340

  • Summary

    This chapter outlines the prenatal imaging and clinical diagnoses of neonatal and pediatric tumors. It discusses the antenatal natural history, and reviews available treatment options during the pre- and postnatal period for fetuses with prenatally diagnosed tumors. The differential diagnosis of a prenatally diagnosed intracranial tumor includes teratoma, which make up the majority of lesions, hemangioma and papilloma. Prenatal ultrasonography and fetal MRI are useful in evaluating and determining the etiology of the intracranial tumor. The surgical approach to bronchopulmonary sequestrations (BPS) is straightforward, with a muscle sparing thoracotomy or thoracoscopic approach for chest lesions and laparotomy or laparoscopy for subdiaphragmatic BPS, with particular attention to first controlling the anomalous blood supply in all cases. The most common primary hepatic tumor is hemangioma, followed by mesenchymal hamartoma, and hepatoblastoma. The differential diagnosis of mesoblastic nephroma includes hydronephrosis and multicystic dysplastic kidney, focal renal dysplasia, and diffuse nephroblastomatosis and nephroblastoma.