• Wen Xu, Qing Wen, Lijing Zha, Chunmei Liu, and Pintong Huang.
• Department of Ultrasound, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
• Medicine (Baltimore). 2020 Dec 4; 99 (49): e23505.

IntroductionCongenital cystic adenomatoid malformation (CCAM) is a rare developmental lung abnormality, that typically manifests in neonates and infants but rarely in adults. Ultrasound is an important method of diagnosing CCAM in neonates and infants; however, few articles have reported the value of transthoracic lung ultrasound in the diagnosis of CCAM in adults.Patient ConcernsWe present a case of a 34-year-old woman with a cavitary lesion in her left lower lobe, that suggested chronic inflammation.DiagnosisThe patient underwent ultrasound examination and contrast-enhanced ultrasound-guided transthoracic core biopsy; histology suggested the diagnosis of lung hamartoma. Surgical resection of the lesion followed by histopathological analysis confirmed the diagnosis of CCAM.InterventionsThe patient underwent transthoracic core biopsy under contrast-enhanced ultrasound guidance. A left lower lobectomy was then performed subsequently.OutcomesThe patient had a smooth recovery and remained asymptomatic during the 12-months of postoperative follow-up.ConclusionWe report a rare case of CCAM to suggest that transthoracic ultrasound combined with contrast-enhanced ultrasound is a safe and effective method of diagnosing the subpleural lung malformations in adults, thereby avoiding multiple radiation exposures and associated complications.

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