Cervical Lymphangioma Research Articles

Prenatal Diagnosis of Lymphangiomas at Unusual Locations: Report of Three Cases

Lymphangioma is a type of developmental abnormality of the lymphoid system that occurs at the site of lymphatic-venous connections. In most cases, lymphangiomas are located in the posterior neck and head as cystic hygroma colli, which are frequently associated with chromosomal abnormalities and various malformation syndromes. Lymphangiomas at locations other than the posterior neck and head are rarely seen. We report the prenatal diagnosis of two cases of intrauterine axillary lymphangiomas and one case of an intraabdominal lymphangioma. The sonographic appearance of these lymphangiomas was a thin-walled, multilocular cyst located in the axillary area or the pelvis. The karyotypes of these babies were normal. One of the babies did well after surgery; one had neurologic sequelae, and one later developed a lymphangioma in the skull. The prognoses of these babies seemed to be better than those with cervical lymphangiomas. However, we are unable to draw any definite conclusions because of the limited number of cases. More investigations should be conducted in the future.

成人に発生した頚部嚢胞状リンパ管腫例

Cervical lymphangioma usually occurs in infants and children as a soft tumor, but it is rarely found in adults. We report a rare case of lymphangioma arising in the right lateral neck of a 44-year-old female. The patient presented with a soft and painless swelling in the right lateral neck. Ultrasound and MRI findings suggested a cystic mass inside the right sternocleidomastoid muscle and the tumor was completely resected under general anesthesia despite some adhesion with the internal jugular vein. Histopathological examination revealed lymphangioma. No recurrence has been noted to date.

Extensive lymphangioma presenting with upper airway obstruction.

To describe the results of an outcome survey of 18 cases of pediatric lymphangioma with dyspnea from encroachment on the tongue base, parapharyngeal space, and/or larynx. Retrospective review of files from January 1983 to September 1998. Pediatric otolaryngology departments from 2 referral centers. Eighteen patients were treated. The average age at initial surgery was 22 weeks (median, 5 weeks). All presented with at least unilateral suprahyoid and infrahyoid cavernous (microcystic) lymphangioma. The tongue base was involved in 11 patients, the parapharyngeal space in 12, and the larynx in 8. Neck dissection was performed initially in all patients. Tracheotomy was performed in 9 patients (50%). Macroglossia was treated by V glossoplasty. Parapharyngeal extensions were treated by cervicotomy or endoscopy, and larynx and tongue base extensions by carbon dioxide laser photocoagulation. Supraglottic laryngectomy was performed in 2 patients. Residual disease, decannulation, duration of tracheotomy, and persistent respiratory symptoms. The average follow-up was 4 years postoperatively. One postoperative death occurred. Sixteen (94%) of the remaining 17 patients had residual lymphangioma. Eight (89%) of the 9 patients with tracheotomy underwent decannulation (average duration, 22 months). Ten patients had persistent symptoms, and 6 were asymptomatic. Involvement of the upper airway seems to be the determining prognostic factor in extensive lymphangioma. Patients with dyspnea by external compression of cervical lymphangioma on the airway responded well to surgery. Aggressive surgical treatment did not seem to significantly improve the prognosis in patients with intrinsic involvement of the upper airway. The natural evolution of untreated massive lymphangioma has not been documented. Less aggressive, symptomatic therapy may be an alternative to avoid mutilating surgery in patients with intrinsic involvement of the airway.

頚部嚢胞状リンパ管腫の４症例

Four patients with cervical cystic lymphangioma were treated in our clinic. Three patients were surgically treated. In 2 of these patients, tumors were completely removed. These tumors showed no invasion of the oral floor, parapharyngeal space or sphenopalatine fossa. A tumor in the third patient could not be completely resected. The tumor had invaded the oral floor, parapharyngeal space and sphenopalatine f ossa. In this patient, the volume of the remaining tumor was decreased postoperatively by local injection of OK-432. One patient did not undergo surgery, and was treated with local injection of OK-432 as the first choice. Since this therapy the tumor has not been palpable. These results suggest that local injection of OK-432 may be the first choice in place of surgical treatment for cases in which incomplete resection or postoperative complications are predicted.

Excision of cervical cystic lymphangioma using injection of hydrocolloid dental impression material. A technical case report

Excision of cervical cystic lymphangioma using injection of hydrocolloid dental impression material. A technical case report

Cervical lymphangioma in an adult

Cervical lymphangioma in an adult

Treatment of cervical lymphangioma using fibrin adhesive : C. Gutierrez San Roman, J. Barrios, J. Lluna, et al. Eur J Pediatr Surg 3:358, (December), 1993

Treatment of cervical lymphangioma using fibrin adhesive : C. Gutierrez San Roman, J. Barrios, J. Lluna, et al. Eur J Pediatr Surg 3:358, (December), 1993

Cystic Lymphangioma and Plunging Ranula Treated by OK-432 Therapy: A Report of Two Cases

Among head and neck angiotumors, cystic lymphangioma occurs in infancy in most cases and it is rare in adulthood. Plunging ranula is one of the diseases which need to be distinguished from lymphangioma, though operation is the first choice therapy for both of these. In the present study, we report on 2 cases in whom we conducted intralesional injection of OK-432 for cervical lymphangioma and ranula found in 20 and 35 year-old female patients. We obtained excellent improvement. First of all, we punctured the tumors and sucked out the liquid content as much as possible, and then used OK-432 in the same volumes to those drawn out. No swelling was observed in either patient after 1 month, and cysts disappeared in CT 4 and 12 months after injection, respectively; at present, the prognosis is satisfactory, without recurrence. The intralesional injection of OK-432 is considered an effective method, as the speed of complete disappearance by this therapy is high. Cosmetically it is superb, leaving no lesions in the skin of the injection site.

Aberrant cervical thymus in children: Three case reports and review of the literature

Aberrant migration of thymic tissue occurs with ectopic thymus in the mediastinum, base of the skull, tracheal bifurcation, and cervical region. A recent review of the literature showed a total of 76 reported cases of aberrant thymus or thymic cysts in patients who presented with primary neck masses. We report three additional cases of ectopic cervical thymus. All three patients presented with asymptomatic cervical masses, and preoperative diagnosis included branchial cleft cyst, cervical lymphangioma, and cervical teratoma. All patients underwent complete surgical resection of the masses. Aberrant cervical thymus rarely produces symptoms because it does not invade contiguous stryctures. Despite its rarity, it should be considered in the differential diagnosis of asymptomatic neck masses in children.

Cervical lymphangioma in the adult.

Cervical lymphangioma is rare among adults. Thirty-two patients with cervical lymphangioma were treated at the Mayo Clinic between 1950 and 1982. The records of these patients were reviewed to investigate the clinical and pathologic behavior of this lesion in persons more than 16 years of age. The lesions were seen in all decades of adult life and equally in men and women. Most lesions presented as a rapidly enlarging, asymptomatic mass. The anterior triangle of the neck was involved nearly as often as the posterior triangle, and right-sided locations predominated (72%). Histopathologic differentiation of the lesions into simplex, cavernous, and cystic lymphangiomas was not helpful in predicting clinical behavior. Surgical excision is the treatment of choice. The lesions may intimately involve the carotid sheath or adjacent nerves. Recurrence in 21% of the 28 patients on whom follow-up data were available mostly represented incomplete excision. Lymphangioma should be included in the differential diagnosis of a large asymptomatic neck mass of recent origin in the adult.