Lymphangioma of the ascending colon

Abstract

Abstract The incidence of lymphangioma is about 0.18%. The 95% of lymphangioma located in the head, neck and axilla. Colonic lymphangioma is even rare and represented in less than 1% of all lymphatic malformations. Therefore, it is difficult for preoperative diagnosis and histological examination might be necessary for conclusive diagnosis. Even the symptoms might be relieved by conservative treatment, but complete surgical resection might be a good choice for colonic lymphangioma according to risks. In our case, a 3-year-old boy presented intermittent fever episodes and abdominal pain. Leukocytosis and escalation of C-reactive protein were noted. The abdominal computed tomography showed homogenous mass without contrast-enhancing and encasement of ascending colon. Acute abdomen due to intra-abdominal infection and mass effect was suspected. Therefore, exploratory laparotomy with hemi-colectomy was done without complication. The final pathology proved lymphangioma of ascending colon. Complete surgical resection was also recommended in all of these cases. However, extensive surgical resection was not available when colonic lymphangiomas were diffused and alternative therapy might be applied, such as intra-cystic sclerotherapy. The prognosis was good. However, long-term surveillance was necessary to assess the recurrence of colonic lymphangiomas.