Diagnosis and management of thoracic cystic lymphangioma

Abstract

<b>Introduction:</b> Cystic lymphangiomas (CL) are benign tumors, that result from abnormal development of the lymphatic system. These cystic formations can be caused by altered embryonic development or chronic obstruction after surgery, infection, or radiation exposure. Thoracic CL are rare and atypical, occurring most commonly in the superior or anterior mediastinum. <b>Aim:</b> Our study aimed to present the diagnosis and management peculiarities of thoracic CL. <b>Methods:</b> We retrospectively reviewed the records of 15 patients managed for thoracic CL in a thoracic surgery department between 1998 and 2020. <b>Results:</b> The mean age of our patients was 27.4 years (1 – 66 years), with a female predominance (9 cases). CL were located in: the chest wall (7 cases), the mediastinum (8 cases), with extension to the cervical region in 1 case. The main reported symptoms were: cough, dyspnea, chest pain, and swelling of the chest wall. Features of thoracic ultrasound were suggestive of the diagnosis for the chest wall location. For the mediastinal location, CL was evoked at CT scan. Complete surgical resection of the CL was performed in all cases. Recurrence was reported in 1 case of scapular CL, 6 months after surgery. <b>Conclusion:</b> Management of thoracic CL varies according to their location in the chest. Although benign, their management may be problematic in case of a bulky lesion. Therefore, CL have to be removed whenever diagnosed.