Prenatal Diagnosis of Horseshoe Lung: A Report of Three Cases and Review of the Literature.

Abstract

Objective: Horseshoe lung is a rare congenital malformation in which the lungs are fused by a parenchymal isthmus. The current literature is very limited regarding cases of prenatal diagnosis and their outcome.

Method: We retrospectively examined three cases of fetuses with horseshoe lung diagnosed antenatally in our center from 2015 to 2024. Additionally, we performed a literature review using a PubMed search (MESH terms: "horseshoe lung" then "horseshoe lung" AND "prenatal").

Results: One case was diagnosed by magnetic resonance imaging (MRI) and two by ultrasound with MRI confirmation. Two patients were referred to our center for diaphragmatic hernia (with a sac in one case). The third patient was referred because of a thoracic aorta on the very left side. After birth, costal anomalies, agenesis of the body and tail of the pancreas, and an associated pelvic kidney were diagnosed. All neonates were presented with acute respiratory distress; two had a favorable outcome, and the third died within the first few days of life.

Conclusion: Horseshoe lung can be diagnosed by ultrasound. The prognostic implications of this malformation remain unclear, particularly given its frequent association with other anomalies, which often are the primary determinants of outcomes.