Thoracic Mass Lesions in Children and their Management: A Prospective Interventional Study

Abstract

Introduction: Thoracic mass lesions in children are heterogeneous group of disorders, out of which developmental malformations such as Congenital Pulmonary Airway Malformation (CPAM), bronchogenic cysts and Congenital Lobar Emphysema (CLE) are common pathology. Primary pulmonary malignancies like carcinoid tumour and pulmonary blastoma may rarely be encountered. Aim: To analyse the clinical pattern, diagnosis and management of children with thoracic mass lesions. Materials and Methods: This prospective interventional study was conducted from June 2018 to May 2021, on 19 patients diagnosed and operated for thoracic mass lesions. It was carried out in the Department of Paediatric Surgery, Sardar Vallabhbhai Patel Post Graduate (SVP PG) Institute of Paediatrics, Srirama Chandra Bhanja (SCB) Medical College, Cuttack, Odisha, India. The final diagnosis was only based on histopathological study. The parameters assessed were demographic features, operative findings and pathological diagnosis. Statistical analysis was done using Microsoft Excel Q1 Macros software. Data was presented as mean, median with Confidence Interval (CI) and percentages (%). Results: A total number of 19 cases were operated, out of which 12 were boys and seven were girls. The median age at presentation was three month (range: five days to five years). Right side of thorax was more commonly affected in 14 cases and left side in five cases. CLE was the most common pathology (eight cases) followed by CPAM (six cases). Bronchogenic cysts and lymphangioma were detected in two cases each. Pulmonary blastoma was the only malignant lesion found. There was no mortality in the present study. Conclusion: The patients with thoracic mass lesions usually present before the age of six months and CLE was detected as the most common finding. A conclusive diagnosis can be obtained only from histopathology