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The abnormal prepartum ultrasonic scan in a case of fetal cystic lymphangioma is presented. A large intrauterine cystic mass adjacent to a 23-week-old fetus was identified by ultrasound. After delivery, this was proved to be a cystic lymphangioma extending from the fetal neck and supraclavicular region.
Vascular malformations of the mediastinum including mediastinal lymphangioma are exceedingly rare in adults. A resected case of mediastinal cystic lymphangioma (cystic hygroma) that presented with acute onset of retrosternal chest pain is reported in a 45-year-old man. Cystic hygromas are benign cysts frequently discovered incidentally on chest radiograph. Although computed tomography scan provides helpful information about the size, density, and site of the cysts, it cannot establish a precise diagnosis concerning its nature. Complete removal of the cyst is the treatment of choice and allows precise diagnosis on histologic examination. However, surgical excision is sometimes difficult, owing to the size and extension of the cysts, infiltrating mediastinal planes, enveloping great vessels, and displacing mediastinal organs without invasion. The difficulty of completely eradicating certain cysts explains cases of insidious progression with compressive recurrence. The subject is succinctly reviewed.
Sixteen cases of cervical cystic lymphangioma are reported; all but two were present at birth. Intra-oral extensions were detected in five and three of these caused macroglossia resulting in partial respiratory obstruction. Mal-development of the jaws and consequent dental malocclusion is a possible complication of the condition. In planning the treatment of such patients, maxillo-facial surgeons and orthodontists should be consulted at an early stage. The treatment of choice is complete excision, but where vital structures are involved repeated sub-total excisions are advocated.
Cystic lymphangiomas are congenital malformations of the lymphatic system that occur most commonly in the nuchal region. Nuchal lymphangiomas are often referred to as cystic hygromas. Few cases of axillary cystic lymphangioma have been reported, but the prognosis of this lesion appears to be less grave than that of its nuchal counterpart. We present 2 cases of axillary cystic lymphangiomas that were diagnosed on prenatal sonography. In 1 case, prenatal sonography showed a multilocular, large cystic mass on the fetal left side, in the area of the lower chest and upper abdomen. The mass extended from at least the level of the umbilicus up to the neck but did not involve the neck. In the second case, prenatal sonography showed a multilocular, septate axillary cystic lymphangioma external to the chest with no flow on Doppler sonography. Follow-up sonography revealed normal fetal growth and enlargement of the cystic mass surrounding the left humerus. Both infants were delivered without complications and have been managed conservatively.
Cystic lymphangioma is an uncommon intra-abdominal lesion that is an occasional incidental finding. We report herein the case of a 27-year-old woman with a 3-year history of abdominal pain due to a large intra-abdominal cystic lymphangioma. The lesion was removed surgically with a complete resection that is the optimal treatment with excellent prognosis.
Cystic lymphangioma (CL) is a rare benign tumour that may arise in various sites. The retroperitoneal site of CL is less frequent than the mesenteric site. It has a polymorphic clinical presentation. The authors report the case of a 60-year-old woman presenting with a mass and pain in the right iliac fossa and right flank. Clinical examination revealed a cystic mass occupying the right flank and right iliac fossa extending as far as the hypogastrium. Medical imaging was in favour of a retroperitoneal cystic mass. Surgical exploration revealed a retroperitoneal cystic mass. Histological examination concluded on retroperitoneal cystic lymphangioma. The diagnosis of CL can be suggested by imaging, either during the antenatal period or in adults, but must be confirmed by histology. The treatment of choice is surgical.
BACKGROUND: Cystic lymphangioma is an uncommon congenital malformation usually encountered in children and often discovered fortuitously. CASE REPORT: A 46-year-old man was hospitalized for acute alcoholic hepatitis with edematoascitic decompensation. The abdominal and pelvic CT scan showed homogeneous hepatomegaly and a tumoral process involving the terminal ileal loops without signs of occlusion or node enlargement. Pathology reported benign mesenteric multicystic lymphangioma. DISCUSSION: Cystic lymphangiomas account for 7% of all intra-abdominal cystic formations. The ileal localization predominates with little or no clinical expression. Ultrasonography and CT scan provide complementary information on the relations with other organs. Magnetic resonance imaging is currently the gold standard allowing precise diagnosis of the anatomic relations and identifying intracystic hemorrhage. The pathology examination is required to eliminate possible benign multicystic mesothelioma which may occasionally take on an aggressive form. Complete surgical excision provides cure.
Retroperitoneal cystic lymphangioma is a rare benign tumor of the retroperitoneal lymphatics that usually manifests in infancy. If surgical excision is used in treatment, it needs to be as complete as possible to reduce the risk of recurrence. Two pediatric patients, an 18-month-old girl and a 4-yearold boy, underwent laparoscopic excision of symptomatic retroperitoneal cystic lymphangiomas. Macroscopically, the resection was complete in both cases. The postoperative course in both cases was uneventful. Both children remained asymptomatic and no recurrence was observed at 18-month follow-up. Complete laparoscopic excision should be considered as a therapeutic option to treat retroperitoneal cystic lymphangioma.
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Abdominal cystic lymphangioma is a very rare congenital tumor of lymphatic origin. It usually appears in the pediatric age and frequently presents with non-specific symptoms and deceptive signs causing, at times, diagnostic dilemmas. Ultrasonography and computer tomography imaging are considered the diagnostic modalities of choice. Two cases of mesenteric cystic lymphangioma, one presenting as perforated appendicitis and the other as recurrent gastritis, are reported. Infection in the first and volvulus in the second case is behind the mode of presentation. The diagnostic approach and treatment are described, with emphasis on the operative tactic applied for upper jejunal resection. A high index of suspicion, accuracy and repeated physical examination and, most important, the liberal use of ultrasonography in all cases of unclear abdominal illness may contribute considerably to a correct diagnosis and decreased morbidity.
Retroperitoneal cystic lymphangioma is a rare benign tumor. Three cases of retroperitoneal cystic lymphangioma with histological proof were reported. Every case revealed similar characteristic appearances on CT, such as 1. unilocular or multilocular cystic mass with homogeneous near-water density, 2. non-enhanced or slightly enhanced wall and septum, 3. commonly thin wall without irregularity, 4. compression of surrounding organs with sharp margin. No secondary changes such as hydronephrosis and ischemic change were noted in the surrounding compressed organs, revealing that this tumor is soft and the growth is slow. Several differential diagnoses were considered, but diagnosis was not so difficult on CT, considering anatomical relations and clinical appearances.
The cystic lymphangioma is a benign slow-growing tumor derived of the lymphatic vessels. It is presented with more frequency in the childhood and the great majority are diagnosed under 5 years of life. The most frequent localization is in head and neck, although they can be developed in any organ or soft tissue. The intraabdominal presentation is not very frequent (2-8%). The clinical presentation is very variable being the most frequent sign the appearance of an effect mass. The diagnosis of suspicion is radiological by means of abdominal ultrasonography and computed tomography. The treatment is surgical. The definitive diagnosis is always histologic. They can recidive. We present two abdominal cases that illustrate this pathology type.
Retroperitoneal cystic lymphangioma is a rare congenital malformation. The majority of lymphangiomas are present at birth and nearly all present before the age of two years. We report a case of giant cystic retroperitoneal lymphangioma in a patient who first presented with symptoms at the age of 7, underwent surgery, and who then suffered a recurrent mass 11 years later.
Lymphangiomas are benign multiloculated cystic tumors. We present radiologic and pathologic findings of a mesenteric lymphangioma containing calcification and mimicking a mesenteric teratoma. This may broaden the differential diagnosis of a cystic mesenteric mass containing calcification.
Management of cystic lymphangioma necessitate for optimal diagnosis and treatment the expertise of a trained multidisciplinary team including dermatologists, radiologists, plastic and vascular surgeons. An initial imaging work-up of these lesions by ultrasound Doppler examination and MR imaging are necessary before treatment planning. Depending of the size, the location, the risk for the adjacent organs, a therapeutic decision may be mandatory. Percutaneous sclerotherapy is a safe and efficient treatment. It is the treatment of choice that must be proposed in first intention.
Cystic lymphangioma is a rare tumour (6% of benign tumours in children), frequently situated in the cervical or axillary region and exceptionally intraabdominal. It arises due to a congenital defect in the connection of the primary lymphatic channels with the central collecting system. It presents clinically either in the form of a pseudo-appendix or pseudo-ascites syndrome or in the form of an abdominal tumour with or without compression of adjacent structures. It can now be easily diagnosed by ultrasonography. Treatment is well defined and consists of surgical resection of the isolated lymphangioma or associated with the adjacent intestine, depending on the site of the tumour. It has a good prognosis.
Cystic lymphangioma is a congenital lymphatic malformation that is a rare cause of extratesticular scrotal masses in children; it is frequently misdiagnosed preoperatively. Complete excision is curative, but recurrence may result from incomplete excision. We report a case of cystic lymphangioma of the scrotum in a 3-year-old boy, which had been previously diagnosed as a hydrocele. Gray-scale sonography showed a multicystic extratesticular lesion; color Doppler sonography further characterized the lesion by showing blood flow within the septa. CT scanning ruled out extrascrotal involvement. The cystic mass was surgically resected. The appearance of the lesion both macroscopically and microscopically was consistent with a diagnosis of cystic lymphangioma. The child recovered uneventfully and was discharged on the third day after surgery; no evidence of recurrence was found in 6 months of follow-up. In such cases of scrotal masses in children, gray-scale and color Doppler sonography, followed by CT or MRI, are useful in diagnosing cystic lymphangioma, differentiating it from other lesions, and defining its extent, thus allowing proper surgical planning.
Cystic lymphangiomas, which are localized on the mesentery of the intestine, are rarely seen. The presence of intestinal atresia together with cystic lymphangioma in the same location has never been described before. In this study, a premature girl weighing 2,630 g who had jejunal atresia, cystic lymphangioma localized in the mesentery of the distal atretic jejunal segment, and multiple rib anomalies is presented. The association of jejunal atresia and cystic lymphangioma may be coincidental, or jejunal atresia may be caused by an intrauterine vascular compression of volvuled cystic lymphangioma. Such an association is being reported for the first time in the literature.