Isolated fetal lymphatic malformation of the thigh: prenatal diagnosis and follow-up.

Huseyin Durukan,Talat Umut Kutlu Dilek,Murside Cevikoglu,Olay Gözükara

doi:10.4322/acr.2017.009

Huseyin Durukan, Talat Umut Kutlu Dilek + Show 2 more

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https://doi.org/10.4322/acr.2017.009

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Abstract

Fetal lymphatic malformation can be found in different parts of the fetal body. It occurs most frequently in the nuchal and axillary region and less frequently in the abdomen or inguinal areas. Lymphatic malformation has been associated with fetal aneuploidy, hydrops fetalis, structural malformations, and intrauterine fetal death.A 31-year-old gravida 3, para 2 woman was admitted to our hospital at 22 weeks of gestation (confirmed by ultrasonographic examination). The fetus was alive, and had a mass derived from the left inguinal region extending to the anterior left leg with fluid-filled cavities about 3–5 cm in size. There was no evidence of intra-abdominal extension of the mass. Amniocentesis was performed. Fetal magnetic resonance imaging revealed a left inguinal cystic mass, which extended to the left thigh. Antenatal follow-up was uneventful. The mother gave birth at term with a cesarean section. Postnatal clinical examination and imaging examination confirmed the diagnosis of lymphatic malformation.Fetal lymphatic malformation carries a high risk of aneuploidy and fetal malformations. Patients diagnosed with lymphatic malformation in antenatal follow-up should be assessed in terms of coexistent anomalies. Fetal karyotyping should be done and the fetus should be monitored for fetal hydrops.

Highlights

Lymphatic malformation is a benign, slow-flow vascular lesion composed of dilated lymphatic channels or cysts lined by endothelial cells with a lymphatic phenotype, occurring in different parts of the fetal body.[1]
Lymphatic malformations have been associated with fetal aneuploidy, hydrops fetalis, structural malformations, and intrauterine fetal death.[3]
We reported the prenatal diagnosis and postnatal progression of a very rare liveborn case with isolated inguinal lymphatic malformation

Summary

INTRODUCTION

Lymphatic malformation is a benign, slow-flow vascular lesion composed of dilated lymphatic channels or cysts lined by endothelial cells with a lymphatic phenotype, occurring in different parts of the fetal body.[1]. Antenatal follow-up was uneventful until the fifth month of gestation, and the first trimester antenatal aneuploidy screening tests were normal. Fetal biometry was appropriate for the gestational age This cystic mass was extending to the left leg until the knee. The possible diagnosis was fetal inguinal lymphatic malformation. The fetal thorax and intra-abdominal organs were normal in the magnetic resonance imaging (MRI) examination (Figure 2). MRI reported an inguinal lymphatic malformation, and an ultrasound revealed there was no fetal anomaly and no apparent invasion of the mass into the abdominal cavity and the intra-abdominal organs. Heart failure developed during the second year of follow-up

DISCUSSION

Findings

CONCLUSION