A multidisciplinary approach to recurrent cervicothoracic cystic hygroma in an adult

A Rare Case of Subclavicular Cystic Lymphangioma in Adults Adhering to Axillary Vessels

Cystic lymphangiomas are rare and benign lymphatic malformations. They often sit in the cervico-facial or axillary region. We report the case of a 31-year-old patient admitted for a left subclavicular mass symptomatic of pain on arm abduction. The CT scan of the chest suggests a cystic lymphangioma adhering to the axillary vascular pedicle. The patient had a complete resection of this mass with a simple postoperative course.

Ethanol ablation for management of large cyst hygroma colli in adult: A case report

INTRODUCTION AND IMPORTANCE

Cystic hygroma in adult is a rare condition that is typically treated with surgery, but in some cases, the cyst may be difficult to completely remove, leading to the potential of recurrence.

CASE PRESENTATION

In this case report, we describe the use of ethanol ablation as an alternative treatment for a rapidly growing cystic hygroma in an adult patient. The patient had a lump on her neck for 2 years that had been slowly growing. The cyst was drained and filled with ethanol, and a drain was left in place for 24 h. Follow-up evaluations showed no evidence of the lump, no pain, and no discharge after 6 months.

CLINICAL DISCUSSION

Cystic hygroma typically affects young children, but it can also occur in adults. It presents as a painless, progressive mass that is soft, fluctuant, and not tender. It is often located in the neck, axilla, or mediastinum, and can also rarely occur in the groin or retroperitoneal spaces. Surgical excision is the primary treatment, but alternatives such as laser surgery, cryotherapy, electrocautery, steroid administration, sclerotherapy, embolization, and radiation therapy have also been used. In this case report, ethanol ablation was used as a sclerosing agent and was successful in treating the patient's cystic hygroma.

CONCLUSION

Ethanol ablation with instillation may be an effective and efficient treatment option for adult single lobe cysts of hygroma colli, but further research is needed to confirm this.

Cystic hygroma of the neck - case report

Cystic hygromas (CHs) are benign congenital malformations of the lymphatic system mainly diagnosed in small children aged less than two years old. They may give a multitude of local, sometimes severe complications. The most used method of treatment is surgical removal. In this paper, we present the case of a CH of a 13-year-old boy, localized in the right lateral region of the neck, diagnosed through magnetic resonance imaging (MRI), with excellent results of the surgical treatment.

GIANT RECURRENT CYSTIC HYGROMA: A CASE REPORT

Cystic hygroma is a benign lymphatic malformation most commonly occurring in the cervico-facial region. It arises from sequestered lymphatic sacs that fail to communicate with the lymphatico-venous system. Although commonly presenting in paediatric age, cystic hygroma can occur at any age. Recurrent cystic hygroma is a known entity and can result from inadequate excision or specific tumour characteristics. We report such a case of giant recurrent cystic hygroma in the neck in a 14 years old female the surgical management of which was challenging due to the large size, previous adhesions and proximity to vital structures.

Endoscope-assisted excision of macrocystic lymphangioma in neck via anterior chest approach in infants and children

OBJECTIVES

Macrocystic lymphangioma of the neck is traditionally removed via an overlying incision near the mass. The resultant scar can be aesthetically displeasing, and endoscope-assistant surgery is still rarely used in pediatric subjects. So we report the endoscope-assisted excision of the macrocystic lymphangioma via anterior chest, and explore its feasibility, validity and security.

METHODS

From June 2005 to December 2008, 6 infants and children with macrocystic lymphangioma accepted endoscope-assisted excision via anterior chest approach.

RESULTS

All procedures were successfully performed using the endoscope-assisted approach. There were no conversions of the operations or postoperative complications. All patients and their parents were satisfied with the cosmetic results.

CONCLUSIONS

Endoscope-assisted excision of the macrocystic lymphangioma via anterior chest approach in children can be applied effectively, safely and feasibly, allowing adequate exposure for dissection, and resulting in a good cosmetic result, and it would be considered as a new surgical approach for these patients.

A frog in the throat? An expansile mass presenting in the neck with dysphonia

A neck mass, which rapidly increases in size over several weeks, is concerning for all involved. When accompanied by other symptoms suggesting sinister underlying pathology, efficient management and rapid diagnosis are vital. The causes may include primary or metastatic carcinoma, or lymphoreticular malignancy. Other non-sinister pathology may account for the swelling such as reactive lymph nodes or benign neoplasms. A benign neoplasm of the lymphatic system known as a lymphangioma may rarely be the cause of a mass in the neck in adults. More commonly found in infants, with approximately 40% found at birth, they are seldom encountered in adults. In children, they have the propensity to infiltrate into and around muscles and neurovascular structures, occasionally leading to difficult surgical excision. The authors present an unusual case of an adult patient with an expansile mass in the supraclavicular fossa of insidious onset. It was associated with dysphagia and hoarseness of voice.

Cystic hygroma in an adult; a case report

Lymphangioma is a benign infiltrative malformation of the lymphatic channels. Cystic lymphangioma or cystic hygroma is a subtype of lymphangioma which exhibits large macroscopic cystic space histologically. The cause of cystic hygroma is believed to be developmental defect or primary Multilocular cystic malformation of dilated lymphatic channels. Cystic hygroma is a common and distinct entity that is not manifested in the oral cavity but occurs in the neck as a large, deep diffuse swelling. They are usually found in the posterior triangle of the neck. They often cross the midline, reaching axilla and mediastinum. Such localization verifies the complexity and extent of the lymphatic system in the cervical region when compared to other regions of the body. The five main locations where cystic hygroma can occur are, cervical (75-90%), axillary (20%), inguinal, retroperitoneal and thoracic. They usually appear as solitary lesions. They are usually infiltrative, often separating fascial planes and incorporating nerves, muscles, and blood vessels. They are fluctuant, freely mobile, compressible, painless and transilluminate well. The skin overlying the lesion is normal and usually there is no associated lymphadenopathy. Various treatment modalities have been tried. Surgery has been the main form of treatment, but total removal is not possible in all cases because of the extent of the lesion, which sometimes involves vital structures. We report a case of cystic hygroma in a young male patient.

Rapid Development of an Axillary Mass in an Adult: A Case of Cystic Hygroma

Cystic hygroma is a congenital anomaly of lymphatic origin, which mainly develops during childhood. Its development in adulthood, however, has been proposed to be related to several predisposing factors such as trauma, infection, tumor growth or iatrogenic stimuli. The development of cystic hygroma in the extremities of adults is extremely rare and moreover, its development in the axillary region has, to our knowledge, been reported only once in the literature. We describe an unusual case of a cystic hygroma which developed rapidly in the axillary region of a female patient in the absence of any predisposing factor. The diagnostic workup and the need for surgical excision of the mass to obtain an accurate, histologic diagnosis is presented.

Cystic lymphangioma confined to mediastinum in an adult

Mediastinal lymphangiomas are very rare tumors among the slow-growing mediastinal masses in the literature. We present the successful resection of a 52-year-old woman who was referred to our hospital. Past medical history consisted of surgical treatment for cervical mass and pathological diagnosis of lymphoma nine years earlier. She underwent postoperative radiotherapy. Preoperative chest roentgenogram and computed tomogram of the chest showed a cystic mass in the anterior mediastinum. The tumor was completely resected. The preoperative diagnosis was never questioned until the histopathological examination confirmed that the lesion was a cystic lymphangioma. Cystic lymphangiomas are benign tumors with the evidence of progression in tumor size and invasion into the vital structures. As our case shows, the tumor involvement with the vital structures causes difficulty in removal.