Introduction: Hybrid lung lesions combining PS and CPAM represent a complex subset of these anomalies. Bilateral PS is an exceptionally uncommon variant, characterized by non-functioning lung tissue supplied by systemic arteries on both sides.

Objective: The first report of a case Series of Hybrid (CPAM) and (PS) and a literature review.

Method: Retrospective review of Case series of hybrid lung lesions (CPAM) and (PS).

Case Report: 

Case 1: A 3-year-old male presented with complicated pneumonia. Diagnosed with a hybrid lung malformation: (CPAM) coexisting with bilateral (PS), on the left lobe and right lower lobe. He underwent left lower lobectomy and coiling of the feeding vessel. This represents the first documented case of a hybrid lesion with bilateral PS, contrasting prior reports of isolated bilateral PS (36 cases globally).

Case 2: A 13-month-old male presented with cough and fever, with a hybrid left lower lobe lesion, underwent surgical resection of the sequestration alongside endovascular coiling and closure device placement to occlude the aberrant feeding vessel.

Case 3: A 14-month-old male presented with cough and fever, with a hybrid left lower lobe lesion, and underwent left lower lobectomy.

Case 4: Term newborn baby girl, with normal birth weight, with respiratory distress in the first day of life, required invasive mechanical ventilation, found to have a hybrid lung lesion in the left lower lobe, underwent thoracotomy at the age of 18 days. 

Conclusion: Understanding these complex congenital anomalies and recognizing unusual presentations is crucial for appropriate patient care. Considering the variety of presenting symptoms and age is important. Management approaches range from conservative to surgical interventions, emphasizing the need for a multidisciplinary approach in diagnosis and treatment.

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