Giant Multicyst Neck Lymphangioma in Adult with Single Session Ethanol Ablation Treatment: Rare Case Report

Abstract

Introduction: Neck lymphangioma is a benign congenital malformation that occurs frequently in children, and is rare in adults. They are usually found in the head and neck region and are often considered a metastatic lesion rather than a primary neoplasia. Most lymphangiomas are acquired at birth which is about 60%, and by the age of 2 years about 80% to 90% are present. The most common location of the abnormality is the submandibular region followed by the parotid gland.
 Case Presentation: A 22-year-old man with complaints of lumps on the right side of the neck that has been getting bigger since 5 months ago. The lump initially appeared the size of a tennis ball, then quickly grew to the size of a watermelon within a month. Physical examination revealed a mass in the right colli region, cystic, fixed, multiple masses of varying size. The core biopsy examination showed the results of lymphangioma. The patient was treated with Ethanol Ablation.
 Discussion: Neck lymphangiomas that are clinically more circumscribed than cavernous lymphangioma. On physical examination, they are soft, with varying sizes and shapes, and will typically grow if not surgically excised. MRI can be useful in determining the extent of anatomical involvement of cystic or cavernous lymphangiomas. Treatment of neck lymphoma is mainly surgical resection. Resection surgery can be associated with complications like lymphatic leaks, fistula formation, chronic wounds, neck on account of mucosal oedema, enlargement of internal lymphangiomas, and loss of neural innervation to the pharynx or tongue. Radiofrequency ablation is a safe, viable alternative and effective debulking treatment of neck lymphangioma.
 Conclusion: We recommend ethanol ablation is a safe, viable alternative and effective debulking treatment of neck lymphangioma and thermal damage to surrounding tissues. This paper constitutes the first report of successful treatment of airway obstruction due to neck lymphangioma.