Purpose or Case Report: Background: Bronchopulmonary foregut malformations are defined as aberrant communications between an isolated segment of respiratory tissue and the esophagus or stomach. Based on the anatomic relationship of the fistulous connection, these rare malformations are classified into four groups (I–IV). Diagnosis typically involves a combination of cross-sectional imaging (CT or MRI) and an upper gastrointestinal series (UGI). Case: A 1-month-old infant with a history of lipomyelomeningocele was transferred from an outside hospital for neurosurgical evaluation. An incidental right lower lobe (RLL) pulmonary mass was identified on spinal MRI. Further evaluation with contrast-enhanced CT revealed a RLL lesion with a systemic arterial supply from the celiac artery. Internal cystic and branching lucencies were also present, raising concern for a hybrid lesion. The patient was discharged, and readmitted four months later for neurosurgical intervention for spinal dysraphism. The admission was complicated by intermittent oxygen desaturations, suspected to be secondary to gastroesophageal reflux. UGI revealed a communication between the lower esophagus and the isolated pulmonary segment in the right medial lung base confirming a diagnosis of group III CBPFM. Conclusions: This case highlights a hybrid lesion (sequestration and CPAM) with rare communication with the gastrointestinal tract, consistent with a communicating bronchopulmonary foregut malformation (CBPFM). Vague symptoms including recurrent pneumonia and workup for feeding intolerance often lead to delayed diagnosis. Surgical excision of CBPFMs is definitive treatment; however, identification of the communicating esophageal component is necessary prior to resection.
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