Concomitant breast and axillary lymphangioma in an adult: A case report and a review of the literature

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.

Rare Cystic Hygroma of the Axilla and Breast in Adults, Case Report, Long-Term Follow-Up and Literature Review: An Experience from Saudi Arabia

Introduction

Cystic hygroma (CH) in adults is a rare condition. Most CH cases are diagnosed at birth or during the first two years of life. Head and neck are the most common sites. There is scanty information about the natural history and follow-up of adult patients with axillary and breast CH. Hence, we present this case to shed some light on the natural history, complications, and a new suggested modality of treatment to deal with the complications.

Case Presentation

We report a case of a 39-year-old female who presented after ten years of excision of the right axillary CH with massive breast edema and recurrence of cysts in the ipsilateral breast and axilla. The insertion treated the edema of a breast-peritoneal shunt.

Discussion

The procedure was performed by inserting a normal V-P shunt catheter without a reservoir through a small incision in the inframammary fold toward the breast and another tiny incision at 10 of the clock in the right breast for fixation in the breast parenchyma. A catheter was inserted through a small incision on the right lumbar spine without intraperitoneal fixation after the catheter was inserted subcutaneously.

Conclusion

This case report shows that adult CH can reoccur. To our knowledge, this is the second case of CH concomitantly involving the breast and axilla. The shunt of the edematous fluid to the peritoneal cavity can give hope for intractable breast edema treatment.

New-onset axillary lymphangioma: a case report

Background

Lymphangioma is a rare diagnosis in adult patients and typically presents in early infancy. These tumors are a result of malformation of the lymphatic vessels and usually involve the head, neck, and axilla.

Case presentation

We report the case of a 28-year-old African female who recently immigrated from East Africa and presented to our surgical breast clinic with a large and rapidly growing left axillary mass. Initial history and evaluation were concerning for hydatid cyst; however, on surgical excision, gross appearance was consistent with cystic lymphangioma. Diagnosis was confirmed on pathology review.

Conclusions

Although lymphangiomas are typically found in young children, adults may develop these tumors in response to unknown triggers. Surgical excision is the preferred treatment.

Lymphangioma of the Lower Lip-A Diagnostic Dilemma: Report of a Rare Case with a Brief Literature Review

Hamartomas are tumor-like deformities typified by cellular propagation indigenous to the original site, although they display growth arrest without the possibility for further growth. Various hamartomatous oral lesions include hemangiomas, lymphangiomas, nevi, odontomas, Cherubism, etc. Lymphangiomas are benign, developmental hamartomatous entities typified by abnormal proliferation of lymphatic vessels. They are usually congenital, and more than 90% of cases occur by 2 years of age, with a rare occurrence in adults. They have a site affinity for the head and neck, and oral lesions are relatively uncommon. The dorsum of the tongue is the commonest oral site of predilection; however, the lip is a rare site of involvement. Hereby, we present an uncommon case of lymphangioma of the lower lip in a 45-year-old male patient, who reported to our hospital with an asymptomatic lower lip submucosal mass present for the last 3 years. Our case is unique as it occurred on the lower lip of a 45-year-old male. A detailed history and clinical evaluation, ultrasonography, and histopathology confirmed the diagnosis of lymphangioma.

Adult axillary lymphangioma removal using indocyanine green fluorescence imaging system: A case report

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Adult cystic lymphangioma is extremely rare.

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Diagnosis of lymphangioma is relatively easy based on the clinical image findings.

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Complete surgical excision is the most effective treatment for lymphangioma.

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The ICG fluorescence imaging system is very useful for performing complete excision.

Introduction

Lymphangiomas are benign cystic tumors which arise from congenital malformations of the lymphatic system and are extremely rare in adulthood. We report a case of adult lymphangioma of the axilla that was removed after identifying the feeding lymphatic vessel using an indocyanine green (ICG) fluorescence imaging system.

Presentation of case

A 35-year old woman presented to our hospital with a rapidly growing mass on her left axilla. She had been pregnant once before and delivered at 34 years of age. Mammography, ultrasonography, and magnetic resonance imaging revealed a tumor that consisted of multiple cysts, which led to a diagnosis of cystic lymphangioma. The ICG fluorescence imaging system indicated that only one lymphatic vessel, which was completely removed with ligation of the feeding lymphatic vessel, was flowing to the tumor. An immunohistological study demonstrated that the cystic endothelia were positive for podoplanin (D2-40), a marker of lymphatic vessels.

Discussion

In addition to congenital factors, mechanical obstruction to lymphatic vessels by an external force, such as trauma or congestion of the lymphatic flow caused by increasing venous pressure during pregnancy or delivery might lead to lymphangioma in adulthood. Therefore, our patient’s pregnancy and delivery one year prior to discovery of the tumor seems to be the cause of her lymphangioma.

Conclusion

Based on our findings, we recommend the complete excision to successfully treat adult-onset lymphangioma. We also suggest that visualization with ICG fluorescence imaging system is very useful for detecting the feeding lymphatic vessel and performing complete excision of the lymphangioma.