Patient Stories
Bronchial Atresia / Lung Mass
Fetal Care Center of Cincinnati Team Changes the Outcome for Caroline Addison
Stacie and John live in Savannah, Georgia, with their 2-year-old son Kegan. When they became pregnant again, Stacie and John 
soon learned that research and a trip to Cincinnati would hold the key to saving baby Caroline's life.
Stacie and John arrived for their baby's 20-week ultrasound on January 19, 2005. Initially, they thought everything checked out fine, but the sonographer soon escorted the couple to an exam room. Stacie's OB / GYN, Jules Toraya, MD, explained that he saw something on the ultrasound but wasn't sure what it was.
Dr. Toraya referred Stacie to a local perinatologist. Five days later, the perinatologist ran a level III ultrasound. (A level III ultrasound details the part(s) of the baby's anatomy where an anomaly has been detected.) Immediately, Stacie and John were told their baby had a Congenital Cystic Adenomatoid Malformation or CCAM. The perinatologist told Stacie and John that he sees, at most, one case of CCAM a year.
A CCAM is an abnormality of the lung. On an ultrasound, this abnormality looks like a solid mass, or tumor. CCAM is best visualized by a combination of ultrasound and fetal MRI. CCAM is a fairly rare condition, and the cause is currently unknown.
Now armed with a diagnosis, Stacie and John started researching CCAM on the internet. John discovered only three places in the United States did fetal surgery for CCAM -- one being the Fetal Care Center of Cincinnati. He and Stacie visited the Fetal Care Center web site and read a fetus with CCAM needs to be checked weekly for any signs that the mass is growing.
Stacie and John contacted Marsha Corbett at the Fetal Care Center of Cincinnati and told her what was happening. They explained they were already planning a trip to Cincinnati in two weeks for their nephew's baptism and asked if they could be seen at this time. Marsha was able to squeeze them into the schedule, and 24 hours later they received their itinerary.
John and Stacie looked up Dr. Crombleholme's background on the internet prior to their visit. "It was very comforting to read about his extensive background and years of expertise in fetal surgery," Stacie and John said.
Stacie was evaluated by the Fetal Care Center of Cincinnati team on February 4, 2005. "Everyone was extremely helpful," John said. "It was to the point that the doctors were personally walking us to our next appointment."
Stacie and John met with the entire Fetal Care Center team at the end of the day to discuss test results and treatment options. They were advised by the team that the baby most likely had CCAM, but another possible diagnosis was bronchial atresia.
Like CCAM, bronchial atresia is an abnormality of the lung. Bronchial atresia is a rare condition that appears as a solid mass on an ultrasound.
The evaluation and test results showed the abnormality was in a favorable prognostic category, which means their baby would more than likely have a favorable outcome based on the diagnosis. Dr. Crombleholme assured John and Stacie their baby was going to be fine. "It felt like a load of bricks was pulled off our shoulders when we were in the meeting that day with Dr. Crombleholme," Stacie said. "John and I both were in tears."
Stacie and John returned home. From week 20 to week 32, Stacie continued to see her OB every Friday for weekly ultrasounds. The results were sent to Dr. Crombleholme, who would call the family at home regularly -- sometimes even on the weekends -- with updates on the baby's condition.
At week 32, as Caroline's lungs developed more fully, the mass was no longer sonographically apparent on the ultrasound, just as Dr. Crombleholme had predicted. (CCAMs or bronchial atresia may become indistinguishable from normal lung tissue at this gestational age.) He advised Stacie and John this was positive news, but it didn't mean they were out of the woods. He told them he wanted to keep in touch.
Caroline was born on Saturday, May 28, 2005. X-rays of Caroline's lung were taken at birth to check the mass. Stacie and John were told that when Caroline was six weeks old, she would need a CT scan to again check the mass in her lungs.
Because of the quality of the care and service they received at the Fetal Care Center of Cincinnati, Stacie and John decided to bring Caroline to Cincinnati Children's Hospital Medical Center for the CT scan, which was scheduled for August 22, 2005. Caroline would undergo surgery the next day if the mass needed to be removed. "Since Cincinnati accommodated us so well, we decided to continue to come here for all of Caroline's treatments and procedures," John said.
Dr. Crombleholme strongly suggested getting the mass out of Caroline's lung while she is still young. If left in, a CCAM or bronchial atresia could potentially cause complications later in life.
In the meantime, Caroline is doing very well and sleeping 8 hours a night. "You would never know we had that scare or that there may still be something in her lungs," Stacie said. And Caroline's big brother, Kegan, really loves her too!
Stacie and John offer this advice to other moms diagnosed with CCAM or bronchial atresia: "Educate yourself. It's important to have an understanding of the diagnosis to make sure everything possible is done." Stacie and John also recommend finding the best doctors who have seen and are experienced with treating this condition.
"We would highly recommend the Fetal Care Center of Cincinnati," Stacie said. "We felt that the whole place was set up just for our family."
Update on Baby Caroline
On August 22, 2005, Stacie, John and baby Caroline returned to Cincinnati Children's for a CT Scan. Afterwards, they met with Dr. Crombleholme, who confirmed the mass was still in Caroline's lungs.
On Tuesday, August 23, Caroline underwent surgery to remove the mass, which was confirmed to be bronchial atresia. The surgery was a success.
In fact, by Sunday Caroline was off Tylenol", which was used to treat her postoperative pain.
Caroline was discharged from Cincinnati Children's two days following surgery, which is very fast. "She's doing wonderful," Stacie said. "A week after her surgery you never would have known she had it."
Today, Caroline is back home with her family and enjoying life as a happy, healthy baby girl. She laughs a lot and enjoys cuddling with a stuffed lamb which has become her favorite toy. Stacie said, "I love this time because Caroline is really starting to develop her personality."
To request an appointment at the Fetal Care Center of Cincinnati or contact us, please use our secure, online appointment form or call 1-888-338-2559 (1-888-FETAL59).
