Doctors in China have managed to shrink a huge tumor that was threatening the life of a fetus in its mother's womb, using a technique based on microwaves, without resorting to surgically opening the uterus.
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This achievement may represent a new treatment option for severe cases of congenital lung malformations in fetuses.
The fetus had a condition known as congenital pulmonary cystic adenoma, a birth defect of the lung that occurs in approximately one in 25,000 to 35,000 pregnancies. In most cases, this defect does not pose a significant risk; however, in some fetuses, the tumor can grow rapidly and become large, compressing the heart and lungs, potentially leading to fluid buildup within the fetus's body, and in severe cases, death.
There is currently no single treatment available for all cases of this malformation. In some cases, steroid medications are used to help shrink the tumor, and in other cases where the cyst is large and filled with fluid, doctors may resort to inserting a needle through the mother's abdomen and uterus to place a tube to drain the fluids, although this procedure may be associated with an increased risk of premature birth.
In more severe cases, a procedure known as fetal lung lobectomy can be performed. This major surgery requires opening the uterus to remove the affected part of the fetal lung and then returning it to the uterus. A study conducted by the University of California, San Francisco indicates that only about 50% of fetuses whose mothers undergo this procedure survive.
In the recent Chinese case, the mother was 40 years old when doctors discovered at 22 weeks of pregnancy that a tumor in the fetus's lung had reached about five centimeters in size, compressing its heart and lungs. Doctors also detected fluid accumulation in the fetus's abdomen at that time, an indication of its deteriorating condition.
To treat the fetus, doctors inserted a thin needle through the mother's abdomen and into the tumor in the fetus's lung, then passed microwave energy through it to the abnormal tissue. This technique heats and destroys the targeted tissue from within by causing water molecules to vibrate and generate heat.
The results showed rapid improvement; the tumor shrank significantly within three days of the procedure, and the fluid buildup in the fetus's abdomen disappeared. The pregnancy continued until the 37th week before the mother delivered her baby via cesarean section. The infant weighed approximately 2.9 kilograms.
Doctors described the procedure as a "new achievement," noting that it represents the first recorded use of microwave ablation technology to treat "congenital pulmonary cystic adenoma" in a fetus.
Despite the promising results, doctors emphasized that a single case is insufficient to determine the safety and effectiveness of the technique, noting the need for more cases and studies before it can be adopted as a treatment option. They added that if the technique proves safe, effective, and reproducible, it could become an additional treatment option for severe cases of congenital pulmonary cystic adenomatous malformation.
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