[size=20px]A 15 month-old boy presents with a cough. A chest x-ray and subsequent CT scan demonstrate a cystic mass in the right lower lobe. Two prenatal ultrasounds showed no evidence of a lung lesion. The most appropriate management is:​

 

A Bronchoscopy

 

B Repeat chest x-ray in three months

 

C Right lower lobectomy

 

D Thoracoscopic wedge resection of cyst

 

E Cyst aspiration and sclerosis​[/size]

E.

C

correct answer

C Right lower lobectomy

​

A cystic lung mass that was not apparent on prenatal ultrasound is suspicious for a Type I pleuropulmonary blastoma. Although a thoracoscopic lobectomy might be feasible, some have advocated an open approach in order to avoid upstaging the tumor. Observation with a follow-up chest x-ray would risk tumor progression. Aspiration or bronchoscopy would also not be appropriate.