Fetal Lung Masses

The Stanford Medicine Children’s Health Fetal and Pregnancy Health Program provides comprehensive evaluation and management of fetal lung masses. Our program combines expertise from specialists in maternal-fetal medicine, neonatology, pediatric radiology, and pediatric surgery to provide comprehensive prenatal and postnatal management of fetal lung masses. We also draw on the skills of our pulmonary and cystic fibrosis teams.

What is a fetal lung mass?

These are masses that grow inside or next to an unborn baby’s lung. They are commonly called bronchopulmonary malformations. Large and complex fetal lung masses can be associated with compression of the developing lung; development of fetal hydrops; polyhydramnios; preterm premature rupture of membranes (PPROM), a rupture of the amniotic sac before labor begins; and preterm birth.

How is a fetal lung mass diagnosed?

A fetal lung mass can be detected on a routine ultrasound.

How does the Lucile Packard Children’s Hospital Stanford team typically treat a fetal lung mass?

The optimal management of fetal lung masses begins in utero and includes complete fetal imaging using ultrasound and MRI.

• Most commonly, in utero treatment of severe lung lesions includes prenatal steroids to slow the growth of the lung mass.
• Large lung masses with a “feeding” blood vessel may be candidates for a minimally invasive in utero therapy using laser coagulation. Large cystic lung lesions may be candidates for drainage using a thoraco-amniotic shunt.
• In all cases, it’s crucial to have a detailed discussion with your multidisciplinary care team at Packard Children’s Hospital to develop an individualized delivery plan.

Babies with lung masses do not usually require surgery right after birth; it’s often done later. But when that is anticipated, delivery may need to be planned in the operating room so that the pediatric surgical team can attend to your baby’s lung mass immediately after delivery, before it can cause serious problems with his or her breathing.

What problems could a fetal lung mass cause after birth?

After the baby is born, the mass may cause difficulty in breathing, or it can decrease the ability of the lungs to fill with enough air. Babies with a large lung mass may need help to breathe and other support from the moment they are born and even surgery soon after delivery. Other babies with smaller masses may be able to be delivered locally but still need close follow-up with pediatric surgery specialists and likely later surgery.

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