Fetal Axillary Cystic Lymphangioma Detected by Prenatal Ultrasonography

Abstract

INTRODUCTIONFetal cystic hygromas are congenital malformations of thelymphatic system appearing as single or multiloculated fluid-filled cavities (1). About 75% of the tumors occur in the neck,with a predilection for the left side, mainly in the posteriortriangle. Ten to twenty percent of the tumors occur in theaxillary region and rare locations include the mediastinum,retroperitoneal area, abdominal viscera, bones, pelvis, groin,scrotum, and the chest wall (2-7). They often progress to hy-drops fetalis and cause fetal death. There is a high prevalenceof associated chromosomal abnormalities, Turner's syndromebeing the most common. Recently, we experienced a case of fetal axillary cystic hy-groma at 38 weeks'gestation in a 30-yr-old multiparouswoman. Here we report this case with a brief review of theliterature. CASE REPORTA 30-yr-old woman with gravida 3 and para 2 was referredat 35 weeks'gestation because of a mass on the left fetal chestwall detected by routine ultrasonography performed at a pri-vate clinic at 34 weeks'gestation. There was no fetal abnor-mality by ultrasonography at 28 weeks'gestation at a privateclinic. The patient's family history and previous medicalhistory were unremarkable. Her first normal child was delivered by cesarean sectiondue to an arrest disorder 4 yr ago and second normal childwas delivered vaginally 2 yr ago. In the current pregnancy,the maternal serum -fetoprotein checked at 16 weeks'ges-tation was normal. Ultrasound examination, performed inour hospital at 35 weeks'gestation, revealed a 6