Mesenteric Cystic Lymphangioma Research Articles

Pediatric patients with mesenteric cystic lymphangioma: A case series

IntroductionMesenteric cystic lymphangioma (MCL) is a benign malformation of the lymphatic system. MCL seldomly occurs with a very rare incidence of around 1: 250,000. This neoplasm is more common in pediatric patients. Symptoms can appear with various clinical features ranging from asymptomatic abdominal mass to acute abdomen. Presentation of casesHere we report four pediatric patients with MCL: two males presented with bilious vomiting and ileus, one female with abdominal pain, and one female with asymptomatic abdominal mass. All patients underwent explorative laparotomy and mass excision was done and/or marsupialization. All patients were discharged at the third – fourth postoperative day uneventfully. DiscussionAlthough benign, lymphangioma can cause other symptoms such as bleeding, torsion, or lymphangioma rupture. Therefore, MCL should be considered as one of the differential diagnoses in acute abdominal and abdominal mass cases in children. ConclusionIn conclusion, although sometimes asymptomatic and found incidentally, the MCL should be resected because it has the potential to grow and invade vital organs and cause life-threatening complications.

Mesenteric cystic lymphangioma: Case report

Cystic lymphangioma is an uncommon, slowly growing tumor derived from of the lymphatic vessels, which is rarely found as intra-abdominal masses usually located in the small-bowel mesentery, followed by the omentum, mesocolon and retroperitoneum. A 66 month –old girl presented with diffuse abdominal distention and severe colicky pain after a 2-month history of abdominal discomfort. Physical examination revealed severe abdominal distention and a palpable abdominopelvic mass localized on the right side of the abdomen. An abdominal CT scan revealed a cystic mass, about 13 × 7 cm × 6.9 cm in size, at the right upper and lower quadrant, which compressed the adjacent bowel loops. The child underwent an emergency laparotomy under general anesthesia. There were two cystic mass (6 × 8 cm and 6 × 7 cm) lesions with cystic and solid areas in the jejunal mesentery adjacent to the bowel wall, about 150 cm from the ileocecal valve. The mesenteric mass was excised with about 10 cm jejunal segment, and bowel continuity was achieved by end-to-end hand-sewn anastomosis. Pathological examination confirmed a diagnosis of mesenteric cystic lymphangioma containing chylous milky fluid. The patient remained well at 3 months from the surgery. Abdominal cystic lymphangiomas is an intra-abdominal cystic mass usually affecting infants and young children, which may be detected incidentally or present with acute life-threatening abdominal obstruction. A total surgical excision seems to be the best therapeutic option in order to minimize the risk of recurrence of symptomatic abdominal cystic lymphangiomas.

Mesenteric cystic lymphangioma: a case report

In adult, cystic lymphangioma of mesentery is an extremely rare manifestation of an intraperitoneal tumor. The clinical presentations of it are variable and occasionally area incidental finding. Herein, we describe a mesenteric cystic lymphangioma in a 39-year-old Iranian woman. The patient was presented with abdominal pain in the periumbilical area from 6 h earlier in the morning. Histopathological review of the excised mass revealed large numbers of cystic lymphatic channels lined by flattened endothelial cells and had smooth muscle bundles in their walls. The patient had an uneventful postoperative period. Although mesenteric cystic lymphangiomas are very rare, the clinical presentations of them are not specific. Therefore, surgeons and pathologist sensitization and awareness about these diagnostic challenges are necessary.

Mesenteric cystic lymphangioma causing jejunal obstruction

Mesenteric cystic lymphangioma causing jejunal obstruction

Incidental finding of 131I uptake in mesenteric cystic lymphangioma on post-therapy 131I SPECT/CT imaging

Incidental finding of 131I uptake in mesenteric cystic lymphangioma on post-therapy 131I SPECT/CT imaging

Incidental finding of 131I uptake in mesenteric cystic lymphangioma on post-therapy 131I SPECT/CT imaging.

Incidental finding of 131I uptake in mesenteric cystic lymphangioma on post-therapy 131I SPECT/CT imaging.

The Patient With Multiple Mesenteric Cystic Lymhangioma Was Treated In Neonatal Perıod Through Prenatal Diagnosis : Case Report And Literature Review

Mesenteric cystic lymphangiomas are benign congenital tumors characterized by proliferation of lymphatic channels. They are an uncommon disorder and constitutes 0.5 % of all lymphangiomas and can cause fatal complications such as volvulus, intestinal obstruction and traumatic or spontaneous rupture, requiring emergency surgery. For this reason, prenatal diagnosis is important. We present a three day old newborn with multiple cystic abdominal lymphangioma treated with resection anastomosis through prenatal diagnosis.

Mesenteric cystic lymphangioma: A case report

Mesenteric cystic lymphangioma: A case report

Benign cystic lymphangioma of sigmoid mesocolon presenting as abdominal catastrophe: an extremely rare entity

Mesenteric cystic lymphangiomas (MCLs) are uncommon benign cystic tumours of unknown aetiology, most often seen in paediatric patients. The clinical presentation ranges from an incidentally discovered abdominal cyst to symptoms of acute abdomen. A10-year-old male presented with generalized abdominal pain, nausea and vomiting & constipation of several hours duration. Emergency laparotomy revealed multiple cystic masses along both the sides of sigmoid colon and mesocolon, which were inflammed mimicking diverticulosis. Sigmoidectomy with colorectal anastomosis was performed. The postoperative course was uncomplicated. MCLs should be included in the differential diagnosis of cystic intra-abdominal lesions. Even when asymptomatic and discovered incidentally, they must be treated surgically because of the potential to grow, invade vital structures and develop life-threatening complications. Health Renaissance 2014;12(2): pp: 130-132

Minilaparoscopic Resection of Mesenteric Cystic Lymphangioma in an Infant

Minilaparoscopic Resection of Mesenteric Cystic Lymphangioma in an Infant

MESENTERIC CYSTIC LYMPHANGIOMA OF MESOCOLIC ORIGIN IN A THREE-MONTH-OLD INFANT: A RARE DIFFERENTIAL DIAGNOSIS OF ABDOMINAL DISTENSION

Cystic lymphangioma is a rare benign tumour occurring during childhood. This tumour, caused by lymphatic system malformations, commonly occurs in head and neck regions. Herein, we report the case of a three-month-old male infant, diagnosed with a large cystic mass in the abdominal cavity and groin. The infant presented with low-grade fever and significant abdominal distension. Abdominal CT scan (with a contrast agent) revealed a large cystic mass in the abdominal cavity. During surgery, the mass was found to originate from the mesentery and was inferiorly connected to the sigmoid colon. Also, a small cystic mass was detected in the left scrotal region. The mass was removed along with a portion of the sigmoid colon and the cyst in the groin. Later on, histopathological examination of the mass confirmed the diagnosis of mesenteric cystic lymphangioma.

Diagnosis and Treatment of Mesenteric Cystic Lymphangioma: Case Report

Background: Mesenteric cysts, and particularly lymphangiomas, occur very rarely in adult patients. Due to this low incidence and their non-specific symptomatology, they often present a difficulty in diagnosis. Case report: We present the case of a patient aged 58 years admitted to the Surgical Clinic 1, Târgu MureE™ Emergency County Hospital accusing diffuse abdominal pain and tenderness in the epigastrium. Abdominal ultrasound revealed a fluid cystic tumor, multi-septated, located in the root of the mesentery and the abdominal computer tomography confirmed this diagnosis. Surgery consisted of total cystectomy without compromising the intestinal segment and sparing the vascular structures in its vicinity. Cyst dimensions were approximately 70x50x30 mm and contained lymphatic fluid. The histopathological report confirmed a mesenteric cystic lymphangioma. The postoperative evolution was uneventful, with quick recovery and no postoperative complications. Conclusions: The diagnosis of mesenteric cyst should be included in the differential diagnosis of intra-abdominal tumors in patients with nonspecific symptoms. Once this diagnosis is established histological differentiation between lymphangiomas and simple lymphatic cyst is essential. The total excision minimizes the recurrence rate, and their early removal can prevent complications caused by the compression and invasion of neighboring organs.

Rare location of mesenteric cystic lymphangioma in an infant

A 2-month-old female infant presented with subacute intestinal obstruction of 1½ month duration. Investigations revealed a cystic intra-abdominal lesion. On exploration, a large multicystic mass was noted in the ileal mesentery with induration and inflammatory interbowel adhesions. It had resulted in bowel volvulus. It was completely excised along with the involved bowel. Histopathologic examination diagnosed the tumor to be a cystic lymphangioma. It is the youngest patient with mesenteric cystic lymphangioma ever reported in the literature.

Cystic lymphangioma of the jejunal mesentery in a young adult: A case report with review of literature

Cystic lymphangioma of the small bowel mesentery is a rare manifestation of an intra- abdominal tumor particularly in adults. 1, 2, 3 The clinical features of intra abdominal lymphangioma are diverse ranging from an asymptomatic abdominal tumor to symptoms of acute abdomen , thus a mass may be discovered incidentally during abdominal examination for an unrelated illness. We hereby present the case of a young adult male with cystic lymphangioma of the jejunal mesentery who presented with an abdominal mass and history of sitophobia. I. Case report: A 20 years old male presented with the complaint of postprandial severe abdominal pain since ten days which was not responding to analgesics. He had sitophobia and significant weight loss. On clinical examination there was disproportionate abdominal sign. X ray abdomen revealed multiple fluid and gas shadows. No abnormal free gas was seen under both domes of diaphragm. Contrast CT Scan abdomen revealed a large hyperintense mesenteric mass at the junction of jejunum and ileum. Rest other routine investigations including hematological and biochemical tests were within normal limits. He had past history of surgery for appendicitis and Meckel's diverticulitis. He underwent elective laparotomy and a large yellowish pink cystic lesion was found in the mesentery at the junction of jejunum and ileum. It was carefully resected along with the segment of jejunum and sent for histopathology. Postoperatively there was no evidence of infection in the drain, which was removed on 8 th day. He was allowed to have food orally on 9 th day, but after eating he developed severe abdominal pain. On examination there was mild tenderness in the left hypochondrium. At emergency laparotomy on the same day, the whole small bowel from 10 cm distal to ileocaecal junction up to the jejunum was found to be gangrenous. Resection and anastomosis was performed. Post operative stay in the hospital was uneventful. The patient was advised regarding long term follow - up that is required to detect recurrence. The surgical specimen obtained from the first surgery consisted of a large yellowish pink cystic mass measuring 19x11x10 cm attached to the mesentery and to the wall of jejunal segment measuring 18 cm in length. The mass showed multiple cystic spaces of varying sizes, cut surface was partly cystic and partly solid. Cystic spaces were filled with milky fluid. Biochemical studies of the fluid revealed high levels of cholesterol and triglycerides. Histological examination revealed multiple dilated channels lined by flattened endothelial cells and separated by collagenous tissue containing small collections of lymphocytes. The dilated lymphatic channels had no connection to normal adjacent lymphatics. The final diagnosis of mesenteric cystic lymphangioma was given. The second operation surgical specimen showed gangrenous changes due to lymphatic obstruction.

Dysontogenetic Pancreatic Cysts in a Patient with a Wallenberg Syndrome

Introduction: Pancreatic cysts are a heterogeneous group of lesions that may be benign or malignant. It is accepted that true cysts occur as a result of developmental anomalies related to the sequestration of primitive pancreatic ducts. Case Presentation: A male patient, 57years old, with previous history of hypertension and cerebrovascular disease (stroke and occlusion of the central retinal vein in 2005) was submitted to abdominal imaging for study of urinary complaints. The imaging study (CT abdominal later complemented by magnetic resonance image) revealed multiple cystic pancreatic formations with associated calcifications without wirsung dilatation or solid nodular lesions suggestive of malignancy. He also had multiple renal cysts and an unilocular cystic lesion suggestive of mesenteric cystic lymphangioma. These lesions were not previously known, neither the patient had symptoms suggestive of pancreatic disease. He was recently diagnosed with acute ischemic stroke in the left half of the medulla oblongata secondary to dissection of an aneurysm of the left vertebral artery (Wallenberg syndrome). There were multiple irregularities in the caliber of the branches of the circle of Willis with dilations and stenosis, setting a vascular pattern of vasculitic type. However, immunological study was negative, with no evidence of retinal abnormalities, including vasculitis. Discussion: Pancreatic polycystic disease is a rare condition, usually asymptomatic, although it may present with nonspecific abdominal pain, vomiting, jaundice or pancreatitis. It may occur singly or in association with renal cysts, liver, central nervous system or retinal abnormalities. Bleeding, infection, rupture or obstruction of the cysts may develop, and treatment includes monitoring, drainage or resection. Conclusion: We present a patient with dysontogenetic pancreatic cysts and no evidence of cystic lesions of the central nervous system. It is questionable whether this patient will have involvement of the central nervous system in the future.Figure

A complicated case of mesenteric cystic lymphangioma (MCL) with resulting short bowel syndrome

Background: Lymphangiomas are benign conditions characterized by proliferation of lymphatic spaces. The most frequent localizations are craniofacial region, neck, chest, and abdomen (5% of cases). Lymphangioma of the small-bowel mesentery is rare, having been reported for less than 1% of all lymphangiomas. MCL is often diagnosed before the fifth year of age (50% of cases are symptomatic by 1 year). Fetal ultrasonography and MRI are important tools in prenatal diagnosis. We report the case of a newborn with a complicated MCL (without prenatal diagnosis) who developed short bowel syndrome due to massive intestinal volvulus. Case report: A male baby (birth weight 3500 g, + 1.95 SDS), born at 36 weeks and 1 day of gestation by cesarean section due to non-reassuring fetal cardiotocography, was admitted to our Neonatal Intensive Care Unit (NICU) at 12 h of life for bilious vomiting and abdominal distension. Pregnancy was unremarkable except for maternal pre-gravidic diabetes treated with insulin; fetal ultrasonographic monitoring was normal. At admission, abdominal palpation revealed a large flank swelling occupying the left side of the abdomen. Ultrasonographic examinations detected an anechoic mass measuring 6 cm. MRI confirmed a large multilocular cystic mass with septations, suspected for MCL, dilated jejunal loops and volvulus of the small bowel. Laboratory results were normal. Emergency surgical intervention was performed on day 2 because of deterioration of clinical conditions: the cystic mass originating from the mesentery was completely excised, and intestinal derotation and enterostomy were performed. Pathologic examination showed a thin-walled multicystic lymphangioma with chylous fluid inside (6 cm in size). A second look procedure was performed on day 45: necrotic bowel was removed and 60 cm of small bowel were left in place. Bowel continuity was not restored and a double enterostomy was created. The patient developed short bowel syndrome which required prolonged parenteral nutrition. Severe cholestasis occurred and was treated with intravenous omega-3 fatty acids emulsion. Discussion: Intestinal lymphangiomas are considered benign tumors, and usually a conservative approach is pursued. Emergency surgery is required in case of complications (intestinal obstruction, volvulus, torsion or rupture of the cyst and obstruction of the urinary tract). Although rare, intestinal lymphangiomas should be considered in differential diagnosis in all newborns with bilious emesis, in order to avoid massive intestinal resection and consequent short bowel syndrome in otherwise healthy babies.

Mesenteric cystic lymphangioma in adult: a case series and review of the literature

the CT scan revealed the presence of multiple ipodense formations in the body and tail of pancreas. Neoplastic markers (AFP, CEA, CA 19-9, CA 15-3, CA125, TPS) were negative. During the hospital stay an abdominal MR was performed. The exam revealed in the retrocecal adipose tissue the presence of a fluid-filled formation with a diameter of 35 mm that appeared indissociable from the cecum for the presence of a tissutal connection (Figure 1 A – B). Other cystic lesions (communicating with pancreatic duct) were present in the whole pancreas and in the right kidney. The patient underwent exploratory surgery: at laparotomy a yellowish ovalar formation with a diameter of 6 cm was found arising from the mesentery of ileum with partial adhesion of the appendix. The lesion had a cystic aspect and was fluid-filled. We performed a total excision of the lesion and appendicectomy. Histopathological examination was consistent with the diagnosis of mesenteric lymphangioma. The patient has been followed-up for 6 months and no recurrence occurred.

Mesenteric cystic lymphangioma causes with abdominal pain: Case report and review of the literature

Mesenteric cystic lymphangioma causes with abdominal pain: Case report and review of the literature

Giant cystic lymphangioma originating from the lesser curvature of the stomach

Cystic lymphangiomas are rare benign tumors. Most frequently occurring in children and involving the neck or axilla, these tumors are much less common in adults and very rarely involve the abdomen. The known congenital and acquired (traumatic) etiologies result in failure of the lymphatic channels and consequent proliferation of lymphatic spaces. This case report describes a very rare case of a giant mesenteric cystic lymphangioma in an adult male with no clear etiology and successful resolution by standard radical resection. A previously healthy 44-year-old male presented with a 6-wk history of progressive upper abdominal pain, vomiting, anorexia and unintentional weight loss accompanied by rapid abdominal distension. A palpable mass was detected upon physical examination of the distended abdomen and abdominal computed tomography scan showed a giant multilobulated cystic process, measuring 40 cm in diameter. Exploratory laparotomy revealed an enormous cystic mass containing 6 L of serous fluid. The process appeared to originate from the lesser omentum and the lesser curvature of the stomach. Radical resection of the tumor was performed along with a partial gastrectomy to address potential invasion into the adjacent tissues. Histological analysis confirmed the diagnosis of a multicystic lymphangioma. The postoperative recovery was uneventful and the patient was discharged after 6 d. At 3-mo follow-up, the patient was in good health with no signs of recurrence.

A case of mesenteric cystic lymphangioma in an adult which caused duodenal stenosis after resection

INTRODUCTIONWe present a rare case of mesenteric lymphangioma in a middle-aged female. PRESENTATION OF CASEA 56-year-old female was admitted to the hospital with upper abdominal pain. Abdominal computed tomography revealed a multicystic mass surrounding the mesentery. We made the decision to resect the mass, suspecting that was a mesenteric lymphangioma based on additional imaging studies. The tumor adhered strongly to parts of the duodenum and the upper jejunum. In order to preserve the jejunum, we dissected its serosa away from the tumor. Approximately 1 week after surgery the patient experienced a constriction of the third portion of the duodenum. Her symptoms were improved with conservative therapy, and she was discharged from the hospital 62 days after surgery. DISCUSSIONLymphangioma originating from the mesentery may have cause adhesions due to exfoliated tumor cells; it is necessary to be concerned about postoperative obstruction. CONCLUSIONThe preoperative diagnosis of lymphangioma is based on various imaging modalities.