Intra-abdominal Cystic Lymphangioma Research Articles

A rare case of intra-abdominal cystic lymphangioma: a case report

An intra-abdominal cystic lymphangioma is a rare benign tumour in adults' uncommon location, originating from lymphatic vessels. Here we present the rare case of 73 year old female presented with right upper abdominal pain, routine blood and radiological investigations done with contrast CT scan showed gastro intestinal stromal tumour over 2nd part of duodenum posteriorly, electively operated and solid cystic mass excised, histopathology showed cystic lymphangioma. The rare looking cystic mass in rare location showing gist/hydatid cyst on CT scan surgical excision showed cystic lymphangioma, where treatment is to excise the mass to prevent recurrence or complications.

A rare occurrence of an incidental primary intra-abdominal Cystic Lymphangioma in a Middle Eastern adult female: A case report.

The authors hereby demonstrate the case of a 46-year-old lady who presented to the outpatient general surgery clinic at our university hospital complaining of chronic right hypochondriac abdominal pain. Investigative radiological imaging marked a cystic formation with well-defined borders and homogenous content extending from the lower pole of the right kidney to the lower hepatic border. Surgical intervention was performed by completely resecting the lesion in question. Directly afterward, histopathological analysis was achieved and established the diagnosis of a CL.Conclusion:CL is a rare neoplasm with ill-defined symptoms and ambiguous clinical presentations. They remain poorly studied due to their rarity and lack of sufficient data in the published literature. This magnifies the importance of clinical awareness and time-efficient surgical intervention. Documenting these cases aids in identifying their subsequent etiological origins, disease-specific risk factors, clinical course, and yields proposals of novel therapeutic approaches.

Intra-abdominal cystic lymphangioma in adults: A case series of 32 patients and literature review

IntroductionCystic lymphangioma (CL) is a benign tumor originating from the lymph vessels. Lymphangiomas in the abdominal cavity are extremely rare, particularly in adults.This article was designed to study the epidemiological, diagnostic difficulties, and therapeutic principles of intra-abdominal cystic lymphangioma (ACL) in adults. Material and methodsWe conducted a single-center, retrospective study of 32 adult patients with ACL admitted to surgical department “A” in “La Rabta Hospital” in Tunis, from January 1998 through December 2020. The demographic, clinical, biological, radiological characteristics, histopathologic, and therapeutic data were collected, as well as the surgical intervention used and the postoperative immediate and late complications. ResultsThirty-two adult patients with ACL were recruited, including 20 females and 12 males. The median age at treatment was 47 (range 14–80) years. The most prevalent sites were the retroperitoneum (25%), the mesentery (21.9%), and the paracolic gutters (n = 18. 7%). Twenty patients underwent open surgery (62.5%), whereas 12 cases (37.5%) had laparoscopic surgery. Twenty-eight patients received total cystectomy (87%). Three recurrences were observed during follow-up (9.4%). ConclusionThe clinical features of CL in adults remain unclear. The diagnosis is only confirmed by histopathological examination after complete surgical resection. The laparoscopic approach is considered safe and feasible.

A case report: 1-year follow-up of giant cystic lymphangioma of right mesocolon

Abstract Introduction: Cystic lymphangiomas are rare benign tumors of the lymph vessels and are usually found in children. However, abdominal cystic lymphangioma in mesocolon is extremely rare in adult patients. Case presentation: We reported a 15-year-old female with giant cystic lymphangioma of the right mesocolon. On examination, only abdominal pain was confirmed. Abdominal computed tomography (CT) showed a large multiseptated cystic mass. The patient underwent a total right mesocolic excision with the lesion. The patient recovered well on postoperative follow-up and was discharged on the fifth day. No evidence of recurrence had also been found during 1-year follow-up period. Conclusion: Complete tumor removal is the optimal choice for the management of intra-abdominal cystic lymphangioma. However, incomplete resection may lead to local recurrence. Keywords: Cystic, Lymphangioma, Mesocolon.

Giant cystic lymphangioma of right mesocolon: A case report.

IntroductionCystic lymphangiomas are rare benign tumors of the lymph vessels and are usually found in children. However, abdominal cystic lymphangioma in mesocolon is extremely rare in adult patients.Presentation of caseWe reported a 15-year-old female with giant cystic lymphangioma of the right mesocolon. On examination, only abdominal pain was confirmed. Abdominal computed tomography (CT) showed a large multiseptated cystic mass. The patient underwent a total right mesocolic excision with the lesion. The patient recovered well on postoperative follow-up and was discharged on the fifth day. No evidence of recurrence had also been found in three months follow-up period.DiscussionThe diagnosis of intra-abdominal cystic lymphoma is often dismissed because the clinical symptoms are nonspecific. It is easy confusion because the ultrasound and CT scan images are relatively similar to the mesenteric and omental cysts. Sclerosing therapies may cause long-term consequences such as local recurrences with a very high proportion. Complete resection, including resection of the involved organs, is necessary. With tumors surrounding the colon, surgeons should consider performing removal block colon-lesion.ConclusionComplete tumor removal is the optimal choice for the management of intra-abdominal cystic lymphangioma. However, incomplete resection may lead to local recurrence.

Cystic Lymphangioma: A Rare Cause of Haemorrhagic Ascites

Lymphangiomas are congenital malformations of the lymphatic system. Multiple intra-abdominal cystic lymphangiomas are rare in adults. Author present a case of a 39-year-old male, presenting with recurrent episodes of haemorrhagic ascites. Laparoscopic biopsy and imaging investigations revealed multiple intra-abdominal cystic lymphangiomas involving the spleen, the liver and the retro-peritoneum. Surgical excision including splenectomy, excision of retroperitoneal and mesenteric lesions was done. The patient has been asymptomatic for 2 years on follow-up.

Ruptured appendicitis associated with intraabdominal cystic lymphangioma and shock

Abstract Acute abdominal pain is a frequently encountered symptom, often indicating a life-threatening, underlying medical condition. Abdominal pain may be caused by peritonitis, usually due to perforate appendicitis, may cause sepsis that can progress to septic shock. A 5-year 8-month-old boy presented to the emergency ward diagnosed with septic shock. He had felt low-grade fever and abdominal discomfort for 5 days in duration. At admission he looked severely ill, hypotensive and tachycardia with narrow pulse pressure. Abdomen was tender on palpation and peritoneal sign was found on the patient. Skin mottling was found with cold extremities. An initial management of septic shock was done. Leukocytosis and high serum C-reactive protein was found. Dengue and typhoid serology were negative. Abdominal radiography, ultrasonography, and CT-Scan with contrast identified several loculated ascites. Surgical exploration found intracystic hemorrhage and multicystic mass rupture within the greater omentum adjacent to the jejunum and ileum. The appendix was dilated and perforated. Cyst resection and appendectomy were performed. Histopathologic examination confirmed acute transmural appendicitis with concurrent cystic lymphangioma of the omentum. Enterococcus faecalis was identified from blood and intra-abdominal culture. Intraabdominal cystic lymphangioma is a rare and possible differential diagnosis in a child presenting with acute abdominal pain.

Lymphangiome kystique intra-péritonéal et maladie de Crohn: à propos d’une association exceptionnelle

Le lymphangiome kystique est une tumeur bégnine malformative rare des vaisseaux lymphatiques à localisations diverses. La localisation intra-abdominale du lymphangiome kystique est moins fréquente comparée à la localisation cervico-axillaire. Sa présentation clinique est polymorphe. Le diagnostic est évoqué par l'imagerie mais il nécessite une confirmation histologique. Le traitement de choix est chirurgical. Nous rapportons ici un cas rare de lymphangiome kystique intrapéritonéale acquis suite à une colectomie subtotale chez une patiente porteuse de maladie de Crohn à géni évolutif sévère et ayant nécessité l'introduction des anti TNF alpha. La patiente s'est présentée pour une masse para médiane droite douloureuse irréductible et non impulsive à la toux faisant retenir le diagnostic d'une éventration étranglée sur cicatrice de laparotomie médiane et amenant à opérer la patiente en urgence. L'exploration chirurgicale a montré une masse multi-kystique intra péritonéale extériorisée en partie à travers l'éventration paramédiane droite. L'examen anatomo-pathologique a permis de confirmer le diagnostic de lymphangiome kystique. Devant une exérèse chirurgicale incomplète, la patiente a eu deux séances de ponction évacuatrice en post-opératoire. C'est le premier cas de lymphangiome kystique rapporté chez un patient sous Anti-TNF alpha. Ceci pourrait être expliqué par la perturbation du système immunitaire et plus spécifiquement la population lymphocytaire. Cette association n'a pas été jusque-là prouvée et des études expérimentales sont nécessaires pour affirmer ou infirmer cette hypothèse.

Intra-Abdominal Cystic Lymphangioma in the Elderly: Case Report and Literature Review

Intra-Abdominal Cystic Lymphangioma in the Elderly: Case Report and Literature Review

Abdominal lymphangioma

Acute abdominal pain is a frequently encountered symptom, often indicating a life-threatening, underlying medical condition. Abdominal pain may be caused by peritonitis, usually due to perforate appendicitis, may cause sepsis that can progress to septic shock. A 5-year 8-month-old boy presented to the emergency ward diagnosed with septic shock. He had felt low-grade fever and abdominal discomfort for 5 days in duration. At admission he looked severely ill, hypotensive and tachycardia with narrow pulse pressure. Abdomen was tender on palpation and peritoneal sign was found on the patient. Skin mottling was found with cold extremities. An initial management of septic shock was done. Leukocytosis and high serum C-reactive protein was found. Dengue and typhoid serology were negative. Abdominal radiography, ultrasonography, and CT-Scan with contrast identified several loculated ascites. Surgical exploration found intracystic hemorrhage and multicystic mass rupture within the greater omentum adjacent to the jejunum and ileum. The appendix was dilated and perforated. Cyst resection and appendectomy were performed. Histopathologic examination confirmed acute transmural appendicitis with concurrent cystic lymphangioma of the omentum. Enterococcus faecalis was identified from blood and intra-abdominal culture. Intraabdominal cystic lymphangioma is a rare and possible differential diagnosis in a child presenting with acute abdominal pain.

Intra-Abdominal Cystic Lymphangioma: Report of 21 Cases

Studying in a retrospective review of 21 cases, diagnostic, therapeutic and evolutionary aspects of intra-abdominal cystic lymphangioma (CL). Methods: Between 1992 and 2014, 21 patients were operated at our institution for a CL. Clinical presentation, location, surgical management and outcome were studied. Results: There were 14 women and 7 men. All CL were diagnosed by abdominal ultrasound and/or abdominal CT scan. The most common site was the retroperitoneum (24%) followed by equally by the mesentery, the mesocolon and abdominal wall. Surgical treatment consisted of a complete resection of cyst in 20 patients. This resection required a splenectomy in one case for a splenic location and digestive resection in 2 cases. Two cases of recurrence of CL were revealed. The first case was a result of partial resection, but the second case occurred in a patient who underwent a total cystectomy. These patients were asymptomatic, so we decided to monitor them. Conclusion: CL in adult is a rare disease. The preoperative diagnostic has benefited from the contribution of imaging mainly ultrasound and CT scan, treatment consisted of surgical complete excision to prevent recurrences.

Intraabdominal Cystic Lymphangiomas in Children: A Single Center Experience

Congenital intraabdominal cystic lymphangiomas (ICLs) are rare disorders. Only a minority of cases present with acute illness, the majority of patients show unspecific abdominal symptoms, and due to the slow progression of ICL the diagnosis is usually made with delay. We report our single center experience concerning ICL covering a 3-year period from 2009 to 2011. During this time three patients with a mean age of 2.8 years were first seen because of unspecific abdominal symptoms, and were identified to have an ICL, originating from the ligamentum gastrocolicum (diameter 17 cm), gastrolienale (diameter 20 cm) and omentum majus (diameter 7 cm). The following report should emphasize the diagnostic difficulty associated with ICL presenting three patients in excellent condition, showing normal laboratory data despite a considerable persistent intraabdominal fluid accumulation. The persistence of “ascites” in parallel with the follow-up sonographies demonstrating cystic masses and internal septations led to the differential diagnosis of an ICL. To us, it seems to be important to bear in mind ICL as a relevant differential diagnosis in children with unspecific abdominal pain or non-specific ascites. This is to point out that especially the existence of septated intraabdominal fluid and cystic structures are strong signs leading to the diagnosis of an ICL. Due to this, the general use of ultrasonography (US) in children with unspecific abdominal symptoms should be recommended. Int J Clin Pediatr. 2014;3(3):89-93 doi: http://dx.doi.org/10.14740/ijcp163w

Surgical Management of Intra‐Abdominal Cystic Lymphangioma. Report of 20 Cases

Cystic lymphangioma (CL) is a benign rare malformation of lymphatic vessels. Its discovery in adults is rare. Although it can affect any organ, the common forms found in adults are mesenteric and/or retroperitoneal CL. This article was designed to study the epidemiological, diagnostic difficulties, and therapeutic principles of intra-abdominal cystic lymphangioma in adults. We report a retrospective study from January 1998 to September 2010 concerning 20 patients who underwent surgical removal of a CL. We were interested in discovering the clinical, biological, and radiological characteristics of CL. The localization, size, and number of cysts have been reported, as well as the surgical intervention used and the postoperative immediate and late complications. The median age was 46 years. Abdominal pain was the main symptom and was found in 15 patients (75%). Physical examination revealed an abdominal mass in 12 patients (60%). In four patients (20%), the cystic lymphangioma was incidental. Abdominal ultrasound and abdominal CT scan helped to highlight 22 cystic masses. CL diagnosis was established preoperatively in 13 patients (65%). Six patients (30%) were operated with a diagnosis other than CL. The diagnosis was made intraoperatively in one case (5%). Only two patients (10%) were operated on in emergency: one due to an infected CL and the other was CL complicated with intracystic hemorrhage. A laparotomy in 13 cases (65%) was the surgical approach used, whereas 7 cases (35%) benefited from a laparoscopy. No conversion was noted. The majority of the patients, 18 cases (90%), received a total cystectomy. Only two patients (10%) had recurrences of which only one was reoperated. The diagnosis of CL often is facilitated by means of modern imaging; however, other diagnoses may be discussed, particularly hydatid disease endemic areas. If symptomatic lesions or complications arise, complete surgical excision, when possible without major sacrifice, seems to be the best therapeutic option to reduce the risk of recurrence.

Intra-abdominal cystic lymphangiomas in children: A case series

Background: Lymphangiomas are hamartomas of lymphatic vessels commonly arising in the head, neck, and axilla. Intra-abdominal cystic lymphangiomas are rare and are located in the retroperitoneum, the mesentery, omentum, or visceral organs. Radiological imaging in the form of ultrasound and computed tomography (CT) scan helps in preoperative diagnosis. The objective of this study is to present the management of children with intra-abdominal cystic lymphangioma in our institution. Materials and Methods: Six cases of intra-abdominal cystic lymphangiomas comprising three males and three females, which presented over 15 months, were studied. Clinical presentation, location, mode of surgical intervention, and outcome were studied. Results: The site of origin was retroperitoneum, omentum, and the mesentery, with two cases of each. Age of presentation ranged from 5 days to 7 years. Abdominal lump was the most common presenting feature. All the patients underwent complete surgical resection - four had open excision, one had a laparoscopy converted to open excision, and one had a complete laparoscopic excision. Postoperative recovery was uneventful in all of them, with no recurrence at 6 months follow-up. Conclusion: Intra-abdominal cystic lymphangiomas in children are usually symptomatic. CT scan is more accurate than ultrasound to diagnose the lesion. Complete excision of the lesion with or without intestinal resection provides symptomatic relief and prevents recurrence.

Congenital abdominal cystic lymphangiomas: what is the correct management?

Introduction: Intrabdominal cystic lymphangioma is a rare benign lesion with a variable clinical presentation. The aim of this study was to evaluate the natural outcome of this lesion and to propose a decision-making protocol for antenatal suspected intrabdominal lymphangioma. We also would like to emphasize the role of laparoscopy in treatment. Materials and Methods: This retrospective study examined 14 cases of intraabdominal cystic lymphangioma in children underwent to our observation, at the Pediatric Surgery Department in Lapeyronie Hospital, Montpellier between 1996 and 2007. Results: Of the 14 patients, 12 were operated on (7 by laparoscopy and 5 in open surgery). In 2 patients we didn’t perform intervention because the lesion was localized in the mesenteric root: we observed a regression of the lesion on US-scan. Conclusion: The intrabdominal cystic lymphangioma is a rare lesion which is now sometimes suspected on antenatal US scan; consequently we observed at the present time an increasing number of lesion potentially asymptomatic: in these case the management has to be established and a risk-benefit balance has to be made before a surgical intervention. Our experience is limited to a small number of cases, and it is too premature to describe any final conclusion; however our suggestion is that clinical course of cystic abdominal lymphangioma is unknown, and we propose that if no complication occurs, a clinical and ultrasonographic monitoring should be done in case of mesenteric root localisation.

Clinical Aspects of Intraabdominal Cystic Lymphangioma in Korea

cystic lymphangioma is an uncommon disease, and rarely develops in the intraabdomen. The aim of this article was to discuss about clinical characteristics of intraabdominal cystic lymphangioma developed in Korea. age, sex, symptoms, locations and size of the lesions, diagnostic methods, treatments, complications and recurrence were analyzed in 13 pathologically confirmed cases of intraabdominal cystic lymphangioma and 18 cases of literature consideration reported in Korea. intraabdominal cystic lymphangioma commonly developed in adults compared to the other lymphangioma, and frequently located in the mesentery. Abdominal pain was the most common symptom, but it was a non-specific finding. Tenderness and abdominal mass were not significantly associated. The size of mass was diverse. Abdominal ultrasonography and abdominal CT were diagnostic tools most commonly used, but preoperative diagnosis was possible only in 22.6%. All patients were discharged without any complications, and no recurrence was reported. preoperative diagnosis of intraabdominal cystic lymphangioma is difficult and symptoms and signs are not specific. Intraabdominal cystic lymphangioma should be suspected in patients with non specific abdominal pain and intraabdominal mass and active diagnostic evaluation is mandatory.

Intra abdominal cystic lymphangioma in an adult

Lymphangiomas are benign abnormal lymphatic channels appearing most commonly in head and neck region in newborns and adults [5]. Intra abdominal lymphangiomas are rare in adult population [2]. They may present at rare and uncommon sites e.g. mesentery, omentum, mesocolon and retroperitoneum [9]. Clinical presentation is variable and misleading, hence complex imaging studies are required in their evaluation [6]. This paper reports a case of abdominal cystic lymphangioma in an adult male. We report this case because of its rarity and variable clinical presentations.

Cystic lymphangioma of the mesentery and hyposplenism in celiac disease

Celiac disease is characterized by intestinal inflammation and mucosal atrophy that improves on a gluten-free diet. Delayed diagnosis can result in diet-refractory disease known as refractory sprue, which is linked to other disorders (intestinal lymphoma, ulcerative jejunoileitis, mesenteric lymph-node cavitation, collagenous sprue, malignancy) and carries a poor prognosis. Here we report the case of a young woman diagnosed with Marsh stage 3C celiac disease with intestinal occlusion due to intra-abdominal cystic lymphangioma mimicking mesenteric lymph-node cavitation, and hyposplenism. Despite a number of prognostically negative features, the disease has been managed successfully for the past 2 years with a gluten-free diet. The pathogenesis, prognosis and therapeutic implications are discussed.

Single-Centre Results of Treatment of Retroperitoneal and Mesenteric Cystic Lymphangiomas

Background: Intra-abdominal cystic lymphangiomas are rare and usually present as benign large cystic masses. The treatment of choice of mesenteric and retroperitoneal cystic lymphangiomas is surgical resection. Methods: Seventeen adults, 11 male and 6 female, with a median age of 39 years were investigated. Presentation, treatment, and outcomes of the mesenteric and retroperitoneal cystic lymphangiomas were analyzed. Results: The most common symptom was abdominal pain. The median tumour size was 12.0 cm in diameter. Patients with retroperitoneal lymphangiomas were younger (p = 0.043). However, 4 out of 8 patients with the mesenteric type required bowel resection (p = 0.064). Magnetic resonance imaging allowed a good differentiation of cystic and septal structures. No postoperative complications occurred, but patients with mesenteric types had longer postoperative stays (7.0 vs. 13.5 days; p < 0.001). The long-term outcome of both groups was satisfactory. Conclusions: The surgical results were good with symptom relief. Bowel resection was common in mesenteric cystic lymphangiomas. Because of its higher resolution, magnetic resonance imaging is suggested.

Intraabdominal lymphangioma: A case report

Discussion Intraabdominal cystic lymphangioma of the mesentery is a rare congenital lesion with a relatively low growth potential. It is typically found in young adults and presents with chronic features. In younger children, the lymphatic malformations are aggressive [2]. Lymphangiomas are prone to recurrence and infiltrating growth. These benign lesions usually present as painless abdominal distension or with complications like volvulus, infection, intracystic hemorrhage and intestinal obstruction. The preoperative diagnosis is difficult, without a high index of suspicion. Most of the cases can be diagnosed USG abdomen [3]. In some cases confirmation of diagnosis may require additional investigations like CT or magnetic resonance Introduction Lymphangiomas are the commonest tumours of infancy and 75% occur in the cervical region. 90% of all lymphangiomas manifest in the initial two years of life. However, intraabdominal lymphangiomas are rare, usually slow growing and manifest in early adulthood [1]. Mesenteric cystic lymphangioma is a rare cause of bowel obstruction and preoperative diagnosis is difficult due to silent clinical course.We present a case of intraabdominal lymphangioma in an infant which presented as a diagnostic dilemma.