1
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Liu J, Zhong ZH, Zheng SS. Characteristics of adult retroperitoneal lymphangioma: a single center Chinese cohort study of 15 cases. Discov Oncol 2024; 15:262. [PMID: 38963421 PMCID: PMC11224209 DOI: 10.1007/s12672-024-01143-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 07/02/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Lymphangioma is a rare cystic tumor that occurs across different locations. Retroperitoneal lymphangioma accounts for about 1% of all lymphangiomas. In this study, we report the clinicopathological features of retroperitoneal lymphangioma and describe our experience in treating this disease. METHODS We collected clinical data from all patients who were pathologically diagnosed with retroperitoneal lymphangioma at Zhejiang Provincial People's Hospital, between June 2013 and August 2022. RESULTS The 7 and 8 male and female patients analyzed herein had a mean age of 48.6 (SD 14.24) years at diagnosis. The mean duration of follow-up was 4.7 years. Among them, 66.67% were asymptomatic, with the rest manifesting abdominal pain, nausea, low back pain and elevated blood pressure as the main symptoms. Preoperative diagnosis and evaluation of cysts were mainly performed via computed tomography (CT) (n = 10, 66.67%) or magnetic resonance imaging (MRI) (n = 8, 53.33%). All patients were completely resected following surgery. Immunohistochemical analysis, performed on 6 patients, revealed that they were positive for D2-40. A total of 4, 4 and 3 patients were positive for CD31, CD34 and SMA, respectively. Moreover, the study cohort had an average postoperative hospital stay of 6.6 days. Follow up, after the end of the study, revealed no relapse in any of the 15 patients. CONCLUSIONS Lymphangioma is a benign tumor of the lymphatic system. Although typical imaging features can be accurate for preoperative diagnosis, histological examination is crucial to final confirmation. Complete surgical resection is the best option to limit the risk of recurrence in cases with symptomatic lesions.
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Affiliation(s)
- Jie Liu
- Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, China
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310003, Zhejiang, China
| | - Zhi-Han Zhong
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310003, Zhejiang, China
| | - Shu-Sen Zheng
- Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, China.
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2
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Su T, Li C, Song B, Song D, Feng Y. Case report and literature review: Giant retroperitoneal cystic lymphangioma. Front Surg 2023; 10:1074067. [PMID: 36733888 PMCID: PMC9887134 DOI: 10.3389/fsurg.2023.1074067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023] Open
Abstract
Background Cystic lymphangioma is a rare benign tumor of the lymphatic system, which is most commonly observed in the neck, head and armpit.Less than 5% of lymphangiomas occur in the abdominal cavity and even less in the retroperitoneum. Case description A 65-year-old male patient was diagnosed with an "abdominal mass that had persisted for 1 year, accompanied by abdominal pain, abdominal distension and dyspnea for 7 days". After abdominal computerd tomography, a giant multilobed abdominal lymphangioma was suspected, which squeezed the intestinal canal and was closely related to the inferior vena cava. The patient underwent an exploratory laparotomy, during which, it was found that the tumor formed extensive adhesions to the transverse colon, small intestine and pelvic wall, and enveloped the abdominal aorta, superior mesenteric artery, inferior mesenteric artery and inferior vena cava to varying degrees. It was diffcult to remove the cyst completely. Postoperative pathology confirmed the diagnosis of retroperitoneal cystic lymphangioma. The patient recovered well after the operation, was eating normally by 5 days postoperatively,and was discharged 10 days postoperatively.The patient was followed up 1 month after postoperatively and no evidence of recurrence was observed. Conclusion In this case, we report a patient with giant retroperitoneal cystic lymphangioma who underwent exploratory laparotomy combined with preoperative abdominal computerd tomography and acute abdominal pain, abdominal distension and dyspnea. Because of the large volume of the tumor and its close relationship with the superior mesenteric artery and other blood vessels, the surgeon used scissors to separate the tumor sharply and removed the whole tumor completely.
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Affiliation(s)
- Tieshan Su
- Departments of Gastrointestinal Colorectal Anus Surgery, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Chaoyuan Li
- Departments of Orthopedics Surgery, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Bin Song
- Departments of Gastrointestinal Colorectal Anus Surgery, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Defeng Song
- Departments of Gastrointestinal Colorectal Anus Surgery, China-Japan Union Hospital, Jilin University, Changchun, China,Correspondence: Defeng Song Ye Feng
| | - Ye Feng
- Departments of Gastrointestinal Colorectal Anus Surgery, China-Japan Union Hospital, Jilin University, Changchun, China,Correspondence: Defeng Song Ye Feng
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3
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Muacevic A, Adler JR. Recurrent Retroperitoneal Lymphatic Malformation in a Pediatric Patient: A Case Report. Cureus 2022; 14:e30846. [PMID: 36457604 PMCID: PMC9705061 DOI: 10.7759/cureus.30846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 01/25/2023] Open
Abstract
Retroperitoneal lymphatic malformations are rare, benign, cystic tumors of the lymphatic system, accounting for 1% of all lymphatic malformation manifestations. Lymphatic malformations are often asymptomatic, but may clinically present with abdominal pain and a palpable mass. Initial diagnostic workup is challenging due to the difficulty of differentiating from masses that may arise from the pancreas, liver, and kidney. This report describes a recurrent retroperitoneal lymphatic malformation in a 15-year-old male. The patient presented with abdominal pain and radiological imaging demonstrated abdominal fluid collection. Following conservative management using aspiration, the patient presented three months later with recurrent abdominal pain. Radiological imaging identified a large thin-walled cystic lesion in the right hemiabdomen containing minimal thin internal septations. Histological analysis confirmed the lymphatic malformation following computed tomography-guided biopsy. The patient underwent aspiration and was referred for outpatient sclerotherapy to prevent future abdominal fluid collection. This case highlights conservative management of recurrent retroperitoneal lymphatic malformation, both on the initial and subsequent presentation.
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4
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Kelly ML. A retroperitoneal lymphangioma in an adult. ANZ J Surg 2021; 92:887-888. [PMID: 34435726 DOI: 10.1111/ans.17162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Madeleine Louise Kelly
- Department of Surgery, Sunshine Coast University Hospital, Birtinya, Queensland, Australia
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5
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Kodera K, Abe K, Kanehira M, Futagawa Y, Okamoto T, Ikegami T. Retroperitoneal lymphangioma mimicking malignant tumor treated by pancreaticoduodenectomy. Clin J Gastroenterol 2021; 14:1791-1797. [PMID: 34386941 DOI: 10.1007/s12328-021-01492-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Abstract
Lymphangiomas are classified as lymphatic malformations, which are more common in children and rare in adults. It frequently occurs in the cervical and axillary regions and uncommonly in the retroperitoneum. A 39-year-old woman presented to our department for the investigation for a 55 mm asymptomatic mass in the right anterior adrenal cavity. Abdominal ultrasound showed a tumor containing cysts in the right anterior adrenal cavity. Contrast-enhanced computed tomography showed that the tumor was poorly contrasted and ill-defined. Magnetic resonance imaging suggested that the tumor contained a small amount of fat. The tumor tended to grow, and the possibility of malignant diseases such as liposarcoma could not be excluded. Therefore, surgical resection was performed. Since intraoperative findings showed that the tumor tightly invaded to the duodenum and pancreatic head, a pancreaticoduodenectomy was selected. The entire tumor was removed without exposing the tumor. Macroscopic findings indicated that the specimen was 55 mm in size, indistinctly demarcated, yellow-white in color, and polycystic. Histologically, lymphovascular proliferation was observed with infiltration of the pancreatic head and the duodenal muscle layer. The diagnosis of lymphangioma was finally made. There was no recurrence 2 years after surgery.
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Affiliation(s)
- Keita Kodera
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, Japan
| | - Kyohei Abe
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae, Tokyo, Japan.
| | - Masaru Kanehira
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae, Tokyo, Japan
| | - Yasuro Futagawa
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae, Tokyo, Japan
| | - Tomoyoshi Okamoto
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae, Tokyo, Japan
| | - Toru Ikegami
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, Japan
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6
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Lim HJ, Tan JWS, Chia CS, Ong CAJ. A rare case of retroperitoneal lymphangioma in a 74-year-old Chinese male. J Surg Case Rep 2021; 2021:rjaa610. [PMID: 33708376 PMCID: PMC7935646 DOI: 10.1093/jscr/rjaa610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/16/2021] [Indexed: 12/04/2022] Open
Abstract
Retroperitoneal lymphangioma is an uncommon and benign mesodermal tumour that arises from the retroperitoneal lymphatics. Notably, it is a rare occurrence in adults, where <200 adult retroperitoneal lymphangioma cases have been published in the literature. Additionally, retroperitoneal lymphangioma is often difficult to diagnose preoperatively and formal diagnosis is frequently determined following surgical exploration. Here, we describe a rare case of retroperitoneal lymphangioma in a 74-year-old man who presented with a 6-month history of intermittent fresh per rectal bleeding with an incidental non-tender left iliac fossa firm mass on examination. Computed tomography scan established a retroperitoneal cystic lesion abutting the aorta and left common iliac vessels. Surgical exploration revealed a large cystic mass and a clean plane of dissection was performed, where the mass was completely excised with all the key structures preserved. Histology was consistent with a retroperitoneal lymphangioma.
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Affiliation(s)
- Hui Jun Lim
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore
| | - Joey Wee-Shan Tan
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore
| | - Claramae Shulyn Chia
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore
| | - Chin-Ann Johnny Ong
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore
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7
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Anbardar MH, Soleimani N, Aminzadeh Vahedi A, Malek-Hosseini SA. Large cystic lymphangioma of pancreas mimicking mucinous neoplasm: case report with a review of histological differential diagnosis. Int Med Case Rep J 2019; 12:297-301. [PMID: 31564993 PMCID: PMC6731960 DOI: 10.2147/imcrj.s218056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 08/24/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose Cystic lymphangioma of the pancreas was first recognized in 1913 as a form of benign cyst. It is extremely rare, accounting for less than 1% of the lymphangiomas. Case report Herein, we report a case of cystic pancreatic lymphangioma diagnosed in a 51-year-old female patient who was hospitalized for a colicky upper abdominal pain for a month. Radiological imaging revealed a large multiloculated cystic pancreatic mass with enhancing septations. The patient underwent distal pancreatectomy, and the histological examination showed cystic lymphangioma. Conclusion Although very uncommon, cystic lymphangioma should be placed in the differential diagnosis list of pancreatic cystic lesions, at least about the multi-septated ones in asymptomatic female patients which are discovered incidentally.
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Affiliation(s)
- Mohammad Hossein Anbardar
- Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.,Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Soleimani
- Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.,Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arian Aminzadeh Vahedi
- Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ali Malek-Hosseini
- Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Surgery, Abualisina Hospital, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
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8
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Suryawanshi PR, Agrawal MM, Rathod MD, Mandhane AM. Laparoscopic excision of a large retroperitoneal lymphovascular malformation in an adult. J Minim Access Surg 2017; 13:66-68. [PMID: 27251838 PMCID: PMC5206844 DOI: 10.4103/0972-9941.181773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Retroperitoneal lymphangioma is a rare benign tumour of the retroperitoneal lymphatics that usually manifests in infancy. It is worth reporting of an unexpected presentation, especially in an adult. They frequently affect the neck (75%) and the axilla (20%). Intra-abdominal lymphangiomas (<5%) have been reported in the mesentery, gastrointestinal tract, spleen, liver and pancreas. Retroperitoneal lymphangiomas account for nearly 1% of all lymphangiomas and are uncommon incidental findings usually at surgery, autopsy or lymphography. Differentiating cystic lymphangiomas from other cystic growths by imaging studies alone is often inconclusive, and surgery is frequently required for definitive diagnosis. An interesting and rare case of a retroperitoneal lymphangioma in an adult patient which was removed laparoscopically is described here.
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Affiliation(s)
- Pravin R Suryawanshi
- Department of Surgery, MGM Medical College and Hospital, Aurangabad, Maharashtra, India
| | - Mohit M Agrawal
- Department of Surgery, MGM Medical College and Hospital, Aurangabad, Maharashtra, India
| | - Mukesh D Rathod
- Department of Surgery, MGM Medical College and Hospital, Aurangabad, Maharashtra, India
| | - Anirudha M Mandhane
- Department of Surgery, MGM Medical College and Hospital, Aurangabad, Maharashtra, India
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9
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DI Marco M, Grassi E, Vecchiarelli S, Durante S, Macchini M, Biasco G. Retroperitoneal lymphangioma: A report of 2 cases and a review of the literature regarding the differential diagnoses of retroperitoneal cystic masses. Oncol Lett 2016; 11:3161-3166. [PMID: 27123082 DOI: 10.3892/ol.2016.4367] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 12/17/2015] [Indexed: 12/15/2022] Open
Abstract
Cystic lymphangioma is a type of benign tumor originating from the lymph vessels. The tumor commonly occurs in childhood, in the head or neck regions, and retroperitoneal localization and presentations in adulthood are rare. Determining a pre-operative diagnosis is often challenging, and in the majority of cases, a diagnosis is only possible subsequent to the histological examination of the surgical specimen. A radical resection is the recommended treatment for cystic lymphangioma, and recurrence is usually due to an incomplete excision of the mass. The present study reports 2 cases of cystic lymphangioma, localized in the pancreatic gland and duodenal wall respectively, which were treated with surgical resection. The study also briefly reviews the literature regarding the differential diagnosis of retroperitoneal cystic masses.
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Affiliation(s)
- Mariacristina DI Marco
- Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, I-40138 Bologna, Italy
| | - Elisa Grassi
- Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, I-40138 Bologna, Italy
| | - Silvia Vecchiarelli
- Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, I-40138 Bologna, Italy
| | - Sandra Durante
- Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, I-40138 Bologna, Italy
| | - Marina Macchini
- Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, I-40138 Bologna, Italy
| | - Guido Biasco
- Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, I-40138 Bologna, Italy
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10
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Izumi D, Toyama E, Shigaki H, Iwagami S, Baba Y, Hayashi N, Watanabe M, Baba H. Laparoscopic excision of an adult retroperitoneal cystic lymphangioma coexisting with an esophageal hiatus hernia. Clin J Gastroenterol 2015; 8:130-3. [PMID: 25998607 DOI: 10.1007/s12328-015-0571-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/05/2015] [Indexed: 11/30/2022]
Abstract
Lymphangiomas are rare cystic tumors that may be present in the retroperitoneum. Retroperitoneal lymphangiomas account for approximately 1% of all lymphangiomas. We experienced an adult patient with a retroperitoneal cystic lymphangioma coexisting with an esophageal hiatus hernia. Abdominal ultrasonography showed a cyst in the abdomen of a 76-year-old woman. She was admitted to our clinic because of an enlargement of the cyst and epigastric pain after meals. She had a long history of heartburn after meals and had not undergone any treatment. She had no record of previous illnesses. Computed tomography revealed a single bunch cystic tumor with septations, located from the mediastinum to the retroperitoneal space. The tumor was not enhanced, and there was no solid part. She was diagnosed with a retroperitoneal cyst. Laparoscopic total excision was performed because the cyst was increasing in size and the patient had symptoms. The cyst was successfully removed. Although laparoscopic excision of retroperitoneal cystic lymphangiomas is the treatment of choice, surgical methods should be carefully chosen in selected patients.
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Affiliation(s)
- Daisuke Izumi
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo, Kumamoto, 860-8556, Japan
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11
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Retroperitoneal lymphangioma in an adult: a case report of a rare clinical entity. Case Rep Surg 2015; 2015:732531. [PMID: 25866696 PMCID: PMC4381689 DOI: 10.1155/2015/732531] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 03/09/2015] [Accepted: 03/10/2015] [Indexed: 01/17/2023] Open
Abstract
Background. Retroperitoneal lymphangioma is a rare, benign mesodermal tumor arising from the retroperitoneal lymphatics which usually presents in infancy and it is worthy to report a case when it has presented in an adult. After a thorough literature search in English we concluded that less than 200 cases of adult retroperitoneal lymphangioma have been reported so far. Apart from being a rare entity it also presents as a diagnostic dilemma and final diagnosis is often made on surgical exploration. Case Presentation. We report a case of retroperitoneal lymphangioma in a 55-year-old male who presented with abdominal distension and dull aching abdominal pain. Conclusion. Retroperitoneal lymphangiomas are rare tumors of infancy but may also present in adults where they are a diagnostic challenge. Differentiating cystic lymphangiomas from other cystic growths by imaging studies alone are often inconclusive and surgery is frequently required for definitive diagnosis and to ameliorate the symptoms.
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12
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Iwamuro M, Kawai Y, Takata K, Okada H, Yamamoto K. Observation of lymphangioma of the duodenum by a magnifying endoscope with a narrow-band imaging system. Case Rep Gastroenterol 2013; 7:229-33. [PMID: 23798913 PMCID: PMC3678144 DOI: 10.1159/000351831] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Among duodenal tumors, lymphangioma is relatively infrequent. In this case report, we describe the case of a 65-year-old Japanese man with duodenal lymphangioma diagnosed by esophagogastroduodenoscopy. Endoscopically, the tumor appeared as a soft submucosal tumor with white spots. When the white spots were grasped by biopsy forceps, milky liquid exuded from the tumor. Additionally, observation by a magnifying endoscope with narrow-band imaging revealed elongated microvessels on the surface. We speculated that this feature was formed because the duodenal villi were dilated and the microvessels were stretched due to the retention of chyle. These endoscopic findings are key features in the diagnosis of duodenal lymphangioma.
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Affiliation(s)
- Masaya Iwamuro
- Department of Gastroenterology, Onomichi Municipal Hospital, Onomichi ; Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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13
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Wang XY, Zhao MF, Ma G, Long J, Guo KJ. Diagnosis and treatment of retroperitoneal lymphangioma: an analysis of 15 cases. Shijie Huaren Xiaohua Zazhi 2011; 19:1968-1970. [DOI: 10.11569/wcjd.v19.i18.1968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To summarize the clinical and imaging characteristics, operative methods and curative effect of retroperitoneal lymphangioma.
METHODS: The clinical and radiological data for 15 patients with retroperitoneal lymphangioma were analyzed retrospectively.
RESULTS: All the patients were diagnosed with retroperitoneal lymphangioma by imaging examination and underwent surgical resection. Pathological examination of resected specimens confirmed the initial diagnosis. The follow-up period ranges from 1 month to 17 years. Relapse occurred in one patient, who subsequently underwent a complete resection and showed no recurrence during one-year follow-up.
CONCLUSION: Retroperitoneal lymphangioma has non-specific clinical manifestations and is easily misdiagnosed. Ultrasound is useful for screening retroperitoneal lymphangioma, while CT can help make a definite diagnosis. Patients with retroperitoneal lymphangioma need to undergo complete resection and often have good prognosis.
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14
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de Zeeuw S, Schouten van der Velden AP, Eggink AJ, Strijk S, Wobbes T. Spontaneous regression of a cystic retroperitoneal tumour in young women postpartum. Report of two cases. Clin Imaging 2011; 35:232-5. [PMID: 21513864 DOI: 10.1016/j.clinimag.2010.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Revised: 06/05/2010] [Accepted: 06/22/2010] [Indexed: 11/28/2022]
Abstract
Retroperitoneal cystic tumours are rarely found, and of these, the most common lesion is a cystic lymphangioma. We present two postpartum patients with a cystic retroperitoneal tumour which showed spontaneous regression and a review of the literature.
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Affiliation(s)
- Sharonne de Zeeuw
- Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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15
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Bhavsar T, Saeed-Vafa D, Harbison S, Inniss S. Retroperitoneal cystic lymphangioma in an adult: A case report and review of the literature. World J Gastrointest Pathophysiol 2010; 1:171-6. [PMID: 21607159 PMCID: PMC3097960 DOI: 10.4291/wjgp.v1.i5.171] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 11/25/2010] [Accepted: 12/02/2010] [Indexed: 02/07/2023] Open
Abstract
Lymphangiomas are rare benign cystic tumors of the lymphatic system. Retroperitoneal lymphangiomas account for 1% of all lymphangiomas, and approximately 186 cases have been reported. They may clinically present as a palpable abdominal mass and can cause diagnostic dilemmas with other retroperitoneal cystic tumors, including those arising from the liver, kidney and pancreas. This report describes the rare case of a cystic retroperitoneal lymphangioma in a 54-year-old male patient. The lymphangioma had progressed to the point of inducing clinical symptoms of abdominal distention, abdominal pain, anorexia, fever, nausea and diarrhea. Radiological imaging revealed a large multiloculated cystic abdominal mass with enhancing septations involving the upper retroperitoneum and extending into the pelvis. Surgical removal of the cyst was accomplished without incident. A benign cystic retroperitoneal lymphangioma was diagnosed on histology and confirmed with immunohistochemical stains.
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Abstract
BACKGROUND Giant cystic lymphangiomas of the liver are rare malformations of the lymphatic system usually found in children. CASE PRESENTATION A 35-year-old man presenting with right upper quadrant abdominal pain for 7 months visited our clinic. Ultrasound, CT, and MRI examination demonstrated a giant cystic mass in the right trisegment of the liver. The patient underwent surgical resection and histological results of the resected specimen confirmed the diagnosis of giant cystic lymphangioma. The right upper quadrant abdominal pain subsided after the surgical resection and the patient recovered well. CONCLUSION Surgical resection is an effective therapy in treating giant cystic lymphangioma.
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18
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Chung SH, Park YS, Jo YJ, Kim SH, Jun DW, Son BK, Jung JY, Baek DH, Kim DH, Jung YY, Lee WM. Asymptomatic lymphangioma involving the spleen and retroperitoneum in adults. World J Gastroenterol 2009; 15:5620-3. [PMID: 19938204 PMCID: PMC2785067 DOI: 10.3748/wjg.15.5620] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Lymphangioma, a benign neoplasm of the lymphatic system, is common in children but rare in adults. Its clinical manifestations include abdominal pain, nausea, vomiting and a palpable mass. However, abdominal sonography or abdominal computed tomography (CT) scan can also incidentally reveal lymphangioma. A larger or symptomatic lymphangioma is treated with total resection to prevent recurrence, infection, torsion and enlargement. Although lymphangioma rarely becomes malignant, its prognosis is generally good. We report a cystic lymphangioma of the spleen and retroperitoneum, which was incidentally found in a 56-year-old man who was hospitalized due to a colon mass. Physical examination showed no specific findings. Abdominal CT revealed a 5.7 cm, non-enhanced multilobulated cystic mass with multiple septa in the spleen and a 10 cm lobulated cystic mass in the paraaortic area. Splenectomy and retroperitoneal resection of the cystic mass were conducted. The endothelium of splenic and retroperitoneal cyst was immunohistochemically stained with D2-40 antibody. The patient was finally diagnosed with splenic cystic and retroperitoneal cavernous lymphangioma.
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Olabanji J, Oladele A, Famurewa O, Adejuyigbe O, Ademola S. Retroperitoneal and genital lymphangioma therapeutic challenges in a developing country. Libyan J Med 2009; 4:44-5. [PMID: 21483503 PMCID: PMC3066714 DOI: 10.4176/081010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Lymphangiomas occur most commonly in the head and neck region, while other sites are rarely affected. A combination of retroperitoneal and genital lymphangioma is very rare indeed. Though congenital, it may persist into adulthood due to missed diagnosis and inadequate or total lack of treatment. MATERIALS AND METHODS A report of a 22-year-old male student who presented with recurrent multiloculated genital, thigh, groin and retroperitneal lymphangioma. He underwent surgical excision and adjuvant sclerotherapy using ethylene-diamine tetra acetic acid. RESULTS AND CONCLUSIONS There was an initial recurrence after surgery which responded satisfactorily to sclerotherapy. Complete surgical excision of lymphangioma may be precluded by vital structures but sclerotherapy produces satisfactory resolution. The difficulties in management with limited facilities for diagnosis and treatment are highlighted.
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Affiliation(s)
- Jk Olabanji
- Department of Surgery, Obafemi Awolowo University, Ile-Ife
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Richmond B, Kister N. Adult presentation of giant retroperitoneal cystic lymphangioma: Case report. Int J Surg 2009; 7:559-60. [DOI: 10.1016/j.ijsu.2009.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Accepted: 09/16/2009] [Indexed: 11/28/2022]
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Retroperitoneal cystic lymphangioma. Indian J Surg 2008; 70:150-1. [DOI: 10.1007/s12262-008-0043-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Accepted: 05/18/2008] [Indexed: 10/21/2022] Open
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Michail O, Michail P, Kyriaki D, Kolindou A, Klonaris C, Griniatsos J. Rapid Development of an Axillary Mass in an Adult: A Case of Cystic Hygroma. South Med J 2007; 100:845-9. [PMID: 17713316 DOI: 10.1097/smj.0b013e3180f60e09] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Othon Michail
- First Department of Surgery, University of Athens Medical School, Greece.
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Elsayes KM, Staveteig PT, Narra VR, Chen ZM, Moustafa YL, Brown J. Retroperitoneal masses: magnetic resonance imaging findings with pathologic correlation. Curr Probl Diagn Radiol 2007; 36:97-106. [PMID: 17484953 DOI: 10.1067/j.cpradiol.2006.12.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Primary retroperitoneal masses are a rare but diverse group of benign and malignant processes. Magnetic resonance (MR) imaging is playing an increasing role in evaluating retroperitoneal soft-tissue masses. Since the MR imaging features of most retroperitoneal soft-tissue masses are nonspecific, prediction of a specific histologic diagnosis remains a challenge for the radiologist. However, there are certain specific MR imaging appearances that are helpful. Dynamic enhancement patterns can reflect the vascularity of masses, differentiating benign from malignant soft-tissue masses. This article pictorially illustrates the MR imaging features of various common and uncommon retroperitoneal masses.
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Affiliation(s)
- Khaled M Elsayes
- Department of Radiology, University of Michigan Health Center, Ann Arbor, MI 48109-0030, USA.
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