Case Report: Cystic lymphangioma of the omentum

Abstract

BACKGROUND: Mesenteric lymphangioma is a rare, benign congenital cystic tumor of the lym-phatic vessels, which occurs in less than 5% pf the cases at the abdomen. They appear most often during childhood. This tumor should be considered as a differential diagnosis of acute abdomen and other abdominal masses. CASE REPORT: A 6-year-old boy presented with abdominal pain and peritonism. He presented a low-grade fever, a positive rebound sign, as well as leukocytosis and neutrophilia. Ultrasono-graphy showed abundant free fluid in abdomen and pelvis. EVOLUTION: Exploratory laparotomy was performed, finding a cystic mass dependent on the greater omentum, this mass was resected. Histopathology was negative for malignancy and compatible with cystic lymphangioma, immunohistochemistry was positive for D2-40 marker. The patient evolved favorably without surgical complications and without evidence of recurrence up to one year of follow-up. CONCLUSION: Mesenteric cystic lymphangioma can present with symptoms of acute abdomen, it can also have a chronic evolution. Complete resection is the treatment of choice, currently minimally invasive procedures are performed with favorable results. Ultrasound is useful for long-term follow-up.