Acute airway obstruction from a laryngeal lymphangioma in a child

Propranolol Alleviating the Challenging Clinical Course of Birth Onset Generalized Lymphangiomatosis. A Case Report

Background: Cystic hygromas, interchangeably named Lymphangiomas, are rare, congenital, benign lesions due to an abnormal lymphatic system development that tend to occur mostly in the head, neck, and oral cavity. Case Presentation: This is a case of 18 year old male patient Syrian, smoker, with a history of multiple cystic hygromas since birth along with a generous surgical history of multiple laparotomies for intrabadominal cystic excisions, splenectomy herniorrhaphies (bilateral inguinal hernias and 2 incisional hernias due to laparotomies) left orchieopexy then testiculectomy, scrotal skin graft , multiple abdominal radioguided cystic drainage and sclerotherapy; presented to our care center for fever, dry cough, pleuretic chest pain, and mild abdominal pain with watery diarrhea. Conclusion: Cystic Hygroma is still being considered as a rare entity and can virtually occur in the whole body sites mostly at head and neck regions as explained above. Challenges in this disease is by finding cases where the presence of such cystic lesions is in extremely rare and unusual sites as well as different treatment modalities and prognostics depending on the site and size of the detected cystic formations.

Lymphatic Malformation of the Nasopharynx in a Young Pregnant Female: A Case Report

BACKGROUND Lymphangiomas represent the focal proliferation of benign, well-differentiated lymphatic tissue. They are most likely congenital, thus more commonly diagnosed at birth and before the age of 2 years. When they are found in adults, they favor the head, neck and axillary region. Rarely do they involve the nasopharynx region or occur in a pregnant patient. CASE REPORT A 21-year-old primagravida in the third trimester of pregnancy developed difficulty swallowing that progressed into difficulty breathing over a 1-month period. Imaging and examination suggested a benign mass in the nasopharynx and the patient underwent surgical removal of the stalk with bipolar cautery. The pathology report revealed a simple 4.5×1.5×0.8 cm lymphangioma. She had no fetal compromise during anesthesia. CONCLUSIONS Surgical removal of a nasopharyngeal lymphangioma during the third trimester of pregnancy is indicated if respiratory obstruction may be a complication.

Retropharyngeal lymphatic malformations: report of two successfully treated cases and review of the literature

Retropharyngeal lymphatic malformations (LMs) are exceedingly rare and have rarely been reported in the literature. This condition can be life threatening, and its management is particularly challenging. Over a two-year period, two patients who presented with symptomatic (dyspnoea, snoring) retropharyngeal LMs were treated in our hospital. Both patients were treated using radiofrequency ablation of LMs through a trans-oral approach and bleomycin sclerotherapy as adjunctive treatment. No major complications occurred following surgery. During follow-up, no recurrence was noted, and both patients were asymptomatic. Our result and the review of the literature suggests that radiofrequency ablation combined with bleomycin sclerotherapy can be a safe and effective treatment.

Oropharyngeal approach as a surgical alternative for cervical lymphatic malformation with airway compression

Cervical lymphatic malformation is an infrequent benign congenital malformation of the lymphatic system, whose rapid growing capacity can compromise the airway. Here we present a 3-month-old male with severe respiratory impairment showing pharyngeal, cervical and mediastinal lymphatic malformation. Transoral surgery maintaining the mucosa allowed removal of numerous cystic lumps occupying the whole pharynx up to the pyriform sinus, surrounding the common carotid artery. Postsurgical MRI showed that the pharynx portion of the lymphatic malformation had disappeared. We conclude that the oropharyngeal approach is an alternative to the classical external surgery involving upper respiratory tract compression.

Cystic hygroma: an overview

Cystic hygromas are the cystic variety of lymphangioma, common locations being cervico-facial regions and axilla. Respiratory distress, recurrent infections or cosmetic reasons are the main indications of the treatment. The ideal treatment is complete surgical excision; however, there is a gradual conversion towards sclerosant therapy. This article reviews the current literature and discusses the various problems encountered during the management of these lesions.

Isolated laryngeal lymphangioma: a rarity

Lymphangiomas are uncommon congenital lesions of the lymphatic system, most often located in the head and neck. Most of these lesions manifest in children less than 2 years of age. Involvement of the larynx in isolation is rare and only a few cases have been reported so far. We report the case of a thirteen-year-old girl who presented with a swelling in the supraglottis. Excision of the mass was done after tracheotomy. Histopathological diagnosis was lymphangioma of the larynx. After a follow up of 15 months the patient is free of recurrence with all functions of larynx being normal.

Burkitt lymphoma in a child with Joubert syndrome

Joubert syndrome is a rare disorder, characterized by hypoplasia, or aplasia of the cerebellar vermis, hypotonia, ataxia, and psychomotor retardation. The molecular basis underlying the disease is still unknown. There are various syndromes, which are associated with malignancies. Previously known associations between Joubert syndrome and tumors, are benign soft tissue tumors of the tongue and laryngeal lymphangioma. This report describes a 17-year-old boy known with Joubert syndrome, who was diagnosed with Burkitt lymphoma. The boy received chemotherapy, which successfully induced complete remission.

Laryngeal lymphatic malformation in a newborn

Stridor in a neonate evokes a series of prompt evaluations to determine the etiology. Common etiologies include inherent structural defects (such as laryngomalacia), vocal fold paralysis, acquired infectious etiologies, or extrinsic compressions. We report a neonate with a lymphatic malformation (lymphangioma) initially confined to the larynx that presented with stridor and progressive respiratory failure. Only seven other cases have been reported to present with lymphatic malformation confined solely to the larynx. There are several different modalities available to treat this condition, but recurrences are common. The presentation and management are discussed below. Physicians should be aware that stridor in a neonate can result from this unusual intrinsic obstruction of the larynx.