Surgical Management of Pulmonary Cystic Adenoid Malformations: A 2011-2024 Retrospective Review of Late Diagnoses

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Introduction: Pulmonary cystic adenoid malformations (PCAM) are rare benign lesions usually diagnosed in the perinatal period but can remain undetected until later in life, often presenting with recurrent pulmonary infections. Patients and Methods: This retrospective study at the thoracic surgery department of Abderrahmane Mami Hospital included patients who underwent surgery for PCAM between 2011 and 2024. Clinical data, diagnostic tests, surgical treatments, and postoperative outcomes were analyzed. Results: Ten patients (mean age: 18 years, range: 15–22, sex ratio: 1.5) were included. The most common symptoms were recurrent pneumonia (80%), chronic cough (60%), and dyspnea (40%). Chest X-rays showed ill-defined opacities in 8 cases (80%), while CT scans revealed parenchymal consolidations in the right lower lobe (70%), right upper lobe (50%), and middle lobe (40%). Bronchoscopy ruled out endobronchial lesions and showed an inflammatory bronchial tree in 90% of cases. Three patients (30%) underwent VATS, while 7 (70%) had a posterolateral thoracotomy. Postoperative recovery was uneventful in 6 patients (60%), while 4 (40%) experienced complications: prolonged air leak (20%) and secondary pneumothorax (20%), all managed effectively with thoracic drainage. No deaths or major long-term complications were reported. Conclusion: Surgical treatment is widely accepted for symptomatic PCAM, while management of asymptomatic cases remains debated. Further studies are needed, especially considering the 5% risk of malignant transformation into bronchiolo-alveolar carcinoma.

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