Sudden Onset, Rapidly Expansile, Cervical Cystic Hygroma in an Adult: A Rare Case with Unusual Presentation and Extensive Review of the Literature

Rare Yet Relevant: Adult Onset Cervical Lymphangioma - Our Experience and Comprehensive Review

Cervical lymphangiomas are anomalies that arise from lymphatic vessels, characterized by gradual and painless growth. While predominantly located in the neck, they may also manifest in the axilla, mediastinum, groin, and abdominal organs. Cervical lymphangioma usually occurs in children and is relatively rare in adults. The purpose of this study was to investigate the characteristics of cervical lymphangiomas in adults. We reviewed the medical records and analysed clinical data obtained from fifteen adult patients who suffered from cervical lymphangioma and were operated from January 2021 to January 2023. Out of 15 cases, 73.3% were females and 26.7% were males. All tumours were unilaterally located. Five patients had prior history of associated dyspnoea / dysphagia. All 15 cervical lymphangiomas (100%) were adjacent to the carotid sheath .Tumour size ranged from 6 cm to 15 cm, with the maximum diameter of ≥ 15 cm in two cases, between 6 cm and 10 cm in eight cases and less than 6 cm in five cases. Further, in this study all cervical lymphangiomas were surgically excised. Postoperative courses were uneventful, and histo-pathological examinations confirmed all cases to be cystic lymphangiomas. A 6 -month follow-up in all 15 cases showed no recurrences. Overall, this study underscores the importance of a multidisciplinary approach involving clinicians, radiologists, and surgeons in the management of adult cervical lymphangiomas, with an emphasis on accurate diagnosis, appropriate classification, and tailored treatment strategies to optimize patient outcomes and minimize complications.

An Unusual Case of Thigh Swelling

Lymphangiomas are benign tumours, almost exclusively found in children. Primary work-up includes imaging. We report a case of lymphangioma in the leg in an adult patient, initially masked as a myxoma. Our patient underwent ultrasound, computerised tomography, and magnetic resonance imaging, which were suggestive of myxoma. Treatment for lymphangioma varies from sclerotherapy to definitive surgical management. In our case, surgical management was selected under consideration of myxoma; however, histopathology confirmed lymphangioma. Lymphangiomas in adult patients can be masked by other conditions and should be considered as a differential in lower leg swellings.

Role of Bleomycin Sclerotherapy as a Non-surgical Method for the Treatment of Cystic Hygroma of Head and Neck Region-an Institutional Study

Cystic hygroma is a benign congenital tumor of lymphatic origin. Most common location is head and neck region. Bleomycin is an antineoplastic glycopeptide antibiotic agent with sclerosing property. In our present study, we used bleomycin for intralesional sclerotherapy for cystic hygromas of head neck region, as an alternative to surgical excision. We also statistically analyzed the pattern of cystic hygroma in head and neck region. Our present study was a prospective observational study of 40 patients. The study period was 18 months. All patients were given intralesional bleomycin at the dose of 0.5 mg /kg body weight, not exceeding 10 units at a time. The injection was repeated if required, at an interval of 4 weeks up to 4-5 times. Each patient was followed up at regular interval up to 1 year. Most common age group was found to be between 0-7 years (55%). Mean age was 6.9 years. Posterior triangle of neck was the commonest site (35%). Excellent response was noted in 24 patients (60%) while good response was noticed in 11 patients (27.5%). Poor response in 5 patients (12.5%). No major side effects noted with bleomycin sclerotherapy. No recurrence was noticed in our study. Intralesional bleomycin is a safe, simple, relatively cheaper and effective nonsurgical treatment method for cystic hygroma of head and neck region. It can be used as a first line treatment modality. Still, a lot of research is needed to establish it as a gold standard treatment modality for cystic hygroma.

A supraclavicular cystic lymphangioma in adult: a rare entity

Cystic lymphangioma is a benign congenital disease that is more seen in head and neck regions. We report a case of a 54-year-old man with a growing supraclavicular mass. The ultrasonography and magnetic resonance imaging suggested a cystic lymphangioma. The mass was surgically totally removed without any recurrence. Histology examination confirmed the diagnosis. Cystic lymphangioma in adults is a rare entity and the literature on the subject is poor with no global recommendations.

Cystic lymphangioma in adult: a case report and a review of the literature

Cystic lymphangioma (CL) in adult is a very rare pathology. Its etiology remains unclear, but it is supposed to be congenital or to be a result of obstruction and lymph fluid retention of developing lymphatic vessels. It generally occurs in the head and neck region, probably because of the rich lymphatics in this area. It can be easily misdiagnosed with other cervicofacial masses. We present the case of a 56-year-old-female presented with a right-sided painless cervical swelling. Ultrasonography and magnetic resonance imaging were performed and a surgical complete removal was carried out. Histological examination revealed that the mass was composed by a variety of dilated lymph vessels involved in a fibrovascular stroma. Diagnose of CL was done. With this article, we want to highlight the features of CL and its role in the differential diagnoses of adults’ cervicofacial masses.

Adult-onset giant cervical cystic hygroma with pressure manifestations on aerodigestive tract, managed surgically: reporting of a rare case

Cystic hygroma is a benign congenital malformation of the lymphatic system that occurs in children younger than two years of age. Hygroma commonly presents in head and neck but can be present anywhere. It is rarely seen in adults. We report the case of a 28-year-old woman who presented with a huge painless right-sided cystic neck swelling of 11 months duration, associated with progressive dysphagia and difficulty in breathing when lying supine or on her left side. Clinically, the swelling occupied both right anterior and posterior triangles of her neck with impalpable right carotid pulsations. Computed tomography revealed a cystic mass lesion. The mass was excised totally through right supraclavicular incision, after identification of the great auricular, spinal accessory and phrenic nerves. Paraffin section confirmed the diagnosis of cystic hygroma. After an uneventful postoperative period the patient was discharged and has had no recurrence to date.