Para-aortic lymphocyst

Pelvic and paraaortic lymphocysts after radical surgery because of cervical and ovarian cancer

To determine the incidence and clinical import of lymphocysts after radical gynecologic surgery including lymphadenectomy, we reviewed the records of 173 patients with cervical cancer and 135 patients with ovarian cancer who were followed up by computed tomography. Lymphocysts were found in 35 (20%) and 43 (32%) of the patients, respectively. Patients with cervical cancer and positive lymph nodes had a significantly higher rate of lymphocyst formation than did those with negative nodes (29% versus 14%, respectively, p less than 0.02). Age, type of lymphadenectomy, volume of fluid furthered by postoperative drains, disease stage, and tumor histology were not related to lymphocyst development. We saw no complications strictly attributable to lymphocysts. The clinical import and treatment possibilities are discussed.

Lymphoceles following second-look laparotomy for ovarian cancer

In patients treated for ovarian cancer it is crucial to distinguish recurrent malignancy from a benign process. Presented herein is a patient who developed bilateral pelvic lymphoceles following a second-look laparotomy for ovarian cancer. Indications for surgical intervention are discussed and the preferred surgical approach is outlined.

Lymphocele after retroperitoneal node dissection for testis tumor

A patient is presented in whom a lymphocele developed after a retroperitoneal lymph node dissection for Stage II embryonal carcinoma of the testicle. The benign nature of this lymphocele has been confirmed not only by the diagnostic procedures outlined, but by its stability over a 42-month follow-up period with no further antitumor therapy. We conclude from reviewing the literature that while aggressive measures are necessary to confirm the diagnosis of a lymphocele, its management should be expectant. If significant obstruction of neighboring structures occurs, an attempt at percutaneous drainage (and possibly sclerosis) seems appropriate despite potential risks of interventional treatment such as hemorrhage and introduction of infection. Open procedures for marsupialization and drainage should be reserved for cases in which more conservative measures fail.

Retroperitoneal lymphocyst: demonstration by lymphangiography

A unique case of a large retroperitoneal lymphocyst producing lateral ureteric displacement is presented. The value of lymphangiography in establishing the diagnosis is stressed.