Cystic pancreatic lymphangioma: a case report

Recurrent giant cystic lymphangioma of peritoneum: a case report and literature review

Cystic lymphangioma (CL) is a rare benign tumor of the lymphatic system, most commonly found in the neck, head, and armpits. The incidence of lymphangiomas in the abdominal cavity is less than 5%, and the incidence of retroperitoneal tumors is even lower. We report here a case of recurrent giant CL that recurred 20 years after the first complete surgical resection. Pelvic MRI at 6 months follow-up after the second complete surgical resection indicated a recurrence of the tumor. The main purpose of this article is to explore the treatment and follow-up strategies for recurrent lymphangioma.

Large cystic lymphangioma of the pancreas: unusual finding with differential diagnosis and therapeutic considerations

Lymphangiomas are rare benign tumours of lymphatic vascular origin. They are more common in the paediatric population and manifest mainly in the neck and axillary region. Retroperitoneal lymphangiomas are <1% and pancreatic origin is even rarer. We present a case of a pancreatic cystic lymphangioma in a 60-year-old woman with chronic diffuse symptoms, diagnosed because of newly onset of diabetes mellitus. She was successfully managed with distal pancreatectomy and spleenectomy en-bloc with the cystic mass without any complications. Cystic lymphangioma of the pancreas is a rare entity presenting with a challenging preoperative diagnosis as imaging modalities may provide ambiguous information. The clinician should be aware of its complicated differential diagnosis and its persistent and subtle symptomatology.

Adult upper-limb forearm lymphoma hygroma (cystic lymphangioma): A case report

INTRODUCTION

Lymphoma hygroma (LH) that is the most common type of lymphangioma, but it rarely occurs in the forearm. It may show localized invasive behavior, but is benign.

CASE PRESENTATION

A 42-year-old woman presented to our hospital with a growing strip-like mass in the right forearm that had been detected 3 years earlier. Ultrasound examination showed a subcutaneous strip of low back vocal cords on the right forearm. Further magnetic resonance imaging (MRI) showed irregular strip-like dilated lymphatic vessels characteristic of LH with low T1 signal intensity and high T2 signal intensity. After radical surgical resection, hematoxylin-eosin (H & E) and immunohistochemical (IHC) staining of cystic LH endothelial cells labeled with monoclonal antibody D2-40 showed a dilated lymphangioma with no evidence of malignancy. After 7 months of follow-up, no tumor recurrence was seen and the effect was satisfactory.

CLINICAL DISCUSSION

A combination of previous trauma history, signs and symptoms, and imaging evaluation are necessary to provide clues to LH, but the final diagnosis is likely to be made by pathologic evaluation of the resected specimen. Although there are many treatment modalities, all also have different outcomes. The absence of complete resection resulting in a tumor remnant is the foremost cause of LH recurrence, so we believe that the preferred approach against LH remains complete surgical resection.

CONCLUSIONS

LH is benign and generally asymptomatic lesions with mild bio-behavior. As there are occasional confusing presentations, similar cystic lesions should still be considered with caution for the disease. Although MRI provides superior advantages for its diagnosis, the confirmation of diagnosis still requires histological examination. Radical lesion resection is a very safe and effective option for the treatment of LH.