Congenital lobar adenomatosis and amniotic band syndrome

Fabrice Cuillier, MD*, D.Ramful, MD**, J.L.Alessandri, MD**

* Department of Gynecology, FĂ©lix Guyon Hospital, 97400 Saint-Denis, Ile de la RĂ©union, France.
** Department of Neonatology, FĂ©lix Guyon Hospital, 97400 Saint-Denis, Ile de la RĂ©union, France.

Case report

A 30-year-old woman, G3 P2 was referred to our antenatal unit at 18 weeks of gestation for twin-to-twin transfusion syndrome. We confirmed the diagnosis and sent her to Necker's hospital in Paris (professor Yves Ville) for the  laser therapy treatment. The laser was successful and patient returned  back at 20 weeks of gestation and was followed-up in a 1-week intervals. 

The ultrasound exam at 22 weeks of gestation revealed a congenital lobar adenomatosis Type 1 of the recipient twin. The finding nearly disappeared at 32 weeks of gestation. We also suspected the amniotic band syndrome of the right hand of the recipient twin.

Patient delivered at 33 weeks of gestation via cesarean section. The donor twin was healthy, 1300 grams. The recipient's weight was 1600 grams. The lobar adenomatosis Type 1 was confirmed. The right wrist showed a constriction ring caused by amniotic band as previously described by ultrasound. Amniotic band syndrome has been described as a rare complication of the laser therapy.

Images 1,2: Image 1, 22 weeks, shows the congenital lobar adenomatosis type 1. Image 2 shows the same finding in 24 weeks.


Images 3,4
: Congenital lobar adenomatosis at 25 and 27 weeks.


Images 5,6: Image 5 shows the lung at 33 weeks. Image 6 shows the 3D image of the left hand which is of normal appearance.


Images 7,8
: Images 7 shows the right hand, arrow indicates the amniotic band. Image 8 shows the right hand after delivery, note the constriction ring at the right wrist corresponding with the ultrasound finding.


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