Purpose or Case Report: We report a case of a term neonate who shortly after birth developed respiratory distress and left-sided pneumothorax. The pneumothorax was drained by a chest tube and the patient was referred to our institution. On day 17 of life a chest Xray and chest CT were performed demonstrating a multiloculated cystic lesion compromising the left upper lobe, most likely representing congenital pulmonary airway malformation (CPAM) type II (Figure 1). No abnormal systemic vessels were identified. At that time the patient was diagnosed with B influenza infection and the surgical intervention was deferred. Over the next several days the patient demonstrated improvement of the respiratory distress and progressive decrease of supplementary oxygen need. On day 25 of life the patient presented significant clinical improvement and, at physical examination, breath sounds were found on the left hemithorax. A follow-up chest xray demonstrated spontaneous resolution of the prior visualized cystic lesion that was confirmed with a chest CT (Figure 2).

Postnatal spontaneous resolution of CPAM have been reported in only few cases, with resolution of the malformation in few months or years. Although we do not have pathologic confirmation, we postulate that our case represent CPAM type II that resolved spontaneously before the first month of life. The management of CPAM diagnosed during the neonatal period remains controversial, some authors recommend postpone surgical intervention in asymptomatic neonates and in patients with prompt resolution of respiratory distress without other significant anomalies.
Our case illustrates the possibility of spontaneous resolution of CPAM and adds to the few reported cases that recommend conservative treatment.
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