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Asadzadeh Aghdaei H, Rabbani A, Sadeghi A, Rezvani H, Sherkat G, Salarieh N, Ketabi Moghadam P. Retroperitoneal lymphangioma as the final diagnosis of a middle-aged woman with abdominal pain: a case report. J Med Case Rep 2023; 17:93. [PMID: 36918898 PMCID: PMC10015658 DOI: 10.1186/s13256-023-03803-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/31/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Lymphangiomas are lesions attributed to congenital malformations of the lymphatic system, or acquired chronic obstruction of the lymphatic network due to trauma, radiation, surgical manipulation, inflammation, or infection. Overall, lymaphangiomas are rare, and particularly, retroperitoneal lymphangiomas are far more uncommon per reported cases. CASE PRESENTATION A 49-year-old Iranian woman presented with a progressive abdominal pain since approximately 1 month before admission. She was found to have a retroperitoneal lymphangioma after a precise radiological and surgical workup. CONCLUSION Retroperitoneal lymphangiomas are rare lesions, sometimes indistinguishable from malignant lesions originating from pancreas and adjacent organs. Complete surgical removal and histologic evaluation of the lesion is the gold standard of treatment and diagnosis.
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Affiliation(s)
- Hamid Asadzadeh Aghdaei
- Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirhassan Rabbani
- Surgery Department of Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Sadeghi
- Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Rezvani
- Division of Medical Oncology, Taleghani Hospital Cancer Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ghazal Sherkat
- Medicine Faculty of Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Naghmeh Salarieh
- Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pardis Ketabi Moghadam
- Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Mesenteric cystic lymphangioma in an adult: An unusual case report. Ann Med Surg (Lond) 2022; 78:103917. [PMID: 35734669 PMCID: PMC9207064 DOI: 10.1016/j.amsu.2022.103917] [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: 04/02/2022] [Revised: 05/26/2022] [Accepted: 06/02/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Cystic lymphangioma is a benign malformation tumor of the lymphatic system. Its location is variable, and mesenteric localization remains extremely rare. Case presentation We describe a rare case of cystic lymphangioma of the mesentery in a 26 years old woman. The diagnosis was suspected following an abdominopelvic computed tomography (CT) and magnetic resonance imaging (MRI), showing a large polylobulated cyst in contact with the stomach, the tail of the pancreas, the spleen, and the antero-external cortex of the left kidney. The patient underwent laparoscopic surgery with a pericystectomy. Pathological examination confirmed the diagnosis of cystic lymphangioma of the mesentery. The patient's postoperative recovery was uneventful. After a Follow up of one year after surgery, there was no evidence of recurrence. Clinical discussion Cystic lymphangioma of the mesentery is a benign malformation tumor of the lymphatic system. Its clinical aspects are very polymorphic; the diagnosis is evoked by radiological imaging but requires pathological confirmation. Surgery is the gold standard in the management of this pathology. Conclusion We highlight the importance of radical surgical resection to avoid Cystic lymphangioma complications and minimize the recurrence risk. The mesenteric location of cystic lymphangioma remains extremely rare. Preoperative diagnosis is usually challenging The final diagnosis is made upon pathology study. Complete en-bloc resection is the gold standard treatement.
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Hamaguchi Y, Arita S, Sugimoto N, Inamoto O, Takagi H, Kogire M, Kitai T. Laparoscopic resection of abdominal cystic lymphangioma derived from lesser omentum: Case report. Medicine (Baltimore) 2020; 99:e18641. [PMID: 31895826 PMCID: PMC6946562 DOI: 10.1097/md.0000000000018641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
RATIONALE Cystic lymphangiomas are uncommon congenital malformations that originate from lymphatic channels. Lymphangiomas frequently appear in the head, neck, and axillary regions of children. Abdominal cystic lymphangiomas are extremely rare, having a reported incidence of 1 in 20,000 to 250,000. PATIENT CONCERNS A 50-year-old female patient was admitted to our hospital with a cough that had persisted for several weeks. Abdominal ultrasonography incidentally revealed a multilocular cystic lesion in the lesser curvature of the stomach. DIAGNOSIS Preoperative findings indicated that the lesion was cystic lymphangioma. However, the possibility of a pancreatic tumor could not be completely excluded. INTERVENTIONS Laparoscopy revealed a multilocular cyst in the lesser curvature of the stomach. The gastrocolic ligament was divided, and the body and tail of the pancreas was exposed in the omental bursa, showing that the cystic lesion was not derived from the pancreas but from the lesser omentum. Although it was located directly beside the left gastric artery, the cyst was enucleated and totally resected laparoscopically without sacrificing the artery. OUTCOMES The cystic lesion was histopathologically diagnosed as an abdominal cystic lymphangioma originating from the lesser omentum. The patient was discharged on the postoperative day 4 without complications. LESSONS Preoperative imaging cannot completely distinguish abdominal cystic lymphangiomas from other types of cystic tumors. Because cystic lymphangiomas have the potential to grow, invade vital structures, and develop life-threatening complications, laparoscopic assessment followed by total resection is considered a useful treatment strategy for peripancreatic cystic lesions.
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Lymphangioma of the Small Intestine Case Report and Review of the Literature. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019. [DOI: 10.2478/sjecr-2018-0001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Lymphangioma usually occurs in children and usually involves the skin. Mesenteric lymphangiomas are extremely rare in adults (1,2,3). Lymphangioma of the small-bowel mesentery is rare, representing less than 1% of all lymphangiomas (4).
We report a case of a 62-year-old female who presented with abdominal pain, discomfort, nausea and vomiting. Pre-operative tests including abdominal ultrasonography and magnetic resonance imaging were performed, but they could not accurately determine the nature of the tumour. Laparotomy was performed; the tumour was excised completely, and a large cystic tumour of the small bowel mesentery was found. Histopathological examination diagnosed the tumour as a cystic lymphangioma. Lymphangiomas are extremely rare, especially in the abdomen of adults, and are asymptomatic for the most part; they often present as acute abdominal conditions, causing life-threatening complications such as secondary infection, rupture with haemorrhage, and volvulus or intestinal obstruction when the tumour increases in size, requiring emergent surgery. Lymphangioma is often difficult to diagnose, and surgical resection is selected in many cases for both diagnosis and treatment.
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5
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Congenital Adrenal Neuroblastoma With and Without Cystic Change: Differentiating Features With an Emphasis on the of Value of Ultrasound. AJR Am J Roentgenol 2016; 207:1105-1111. [PMID: 27556888 DOI: 10.2214/ajr.16.16452] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the features of congenital adrenal neuroblastomas with and without cystic changes and to emphasize the value of ultrasound in the diagnostic evaluation of cystic congenital adrenal neuroblastoma. MATERIALS AND METHODS A total of 41 patients with surgically confirmed congenital adrenal neuroblastoma were enrolled. We divided the patients into two groups according to presence or absence of cystic change in the tumor, as determined from the initial ultrasound findings. Clinical and laboratory findings, disease stage, and patient outcome were investigated with a statistical comparison between the two groups. The imaging findings for cystic congenital adrenal neuroblastoma were reviewed to compare the additional diagnostic value of CT and MRI when paired with ultrasound. RESULTS There were 22 patients (54%) in the group without cystic changes and 19 patients (46%) in the group with cystic changes. Prenatal detection and absence of metastasis were significantly more common in the cystic group than in the noncystic group (p < 0.05). Sensitivities of tumor marker levels were also significantly lower in the cystic group. Patient outcome was excellent, and there was no significant difference between the groups. With regard to imaging of cystic congenital adrenal neuroblastoma, in the 15 cases in which CT or MRI was paired with ultrasound, no additional diagnostic information was discerned with CT or MRI. CONCLUSION Nearly one-half of congenital adrenal neuroblastomas are cystic, and these tumors have clinical and laboratory features that distinguish them from noncystic congenital adrenal neuroblastoma. Diagnostic tests, including CT, MRI, and assessment of tumor markers, have low diagnostic value in the evaluation of cystic congenital adrenal neuroblastoma.
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Lee HH, Lee SY. Case report of solitary giant hepatic lymphangioma. KOREAN JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY 2016; 20:71-4. [PMID: 27212994 PMCID: PMC4874048 DOI: 10.14701/kjhbps.2016.20.2.71] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 01/12/2016] [Accepted: 01/18/2016] [Indexed: 01/16/2023]
Abstract
A hepatic lymphangioma is a rare benign neoplasm that is usually associated with systemic lymphangiomatosis. A solitary hepatic lymphangioma is extremely rare. Therefore, we present a rare case of a female patient who underwent right hepatectomy for solitary giant hepatic lymphangioma. A 42-year-old female presented to the emergency department with complaint of severe abdominal pain of the right upper quadrant. Abdominal computed tomography showed an approximately 23×30-cm sized, giant, relatively well-defined, homogenous cystic mass with few septa in the right liver (segments VII and VIII). The preoperative diagnosis was a giant hepatic cystadenoma or cystadenocarcinoma. We performed right hepatectomy. The permanent histopathological report revealed cystic lymphangioma of the liver. Although the prognosis of solitary hepatic lymphangioma after surgical resection is favorable, recurrence has been reported in literature.
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Affiliation(s)
- Hwan Hyo Lee
- Department of Surgery, Gimpo Woori Hospital, Gimpo, Korea
| | - Seon Youl Lee
- Department of Radiology, Gimpo Woori Hospital, Gimpo, Korea
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Acute Abdominal Pain Caused by an Infected Mesenteric Cyst in a 24-Year-Old Female. Case Rep Radiol 2016; 2016:8437832. [PMID: 27190668 PMCID: PMC4844871 DOI: 10.1155/2016/8437832] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 03/30/2016] [Indexed: 11/25/2022] Open
Abstract
A mesenteric cyst is a rare cause for abdominal pain. This umbrella term includes cystic entities which reside in the mesentery. We present a case of an infected false mesenteric cyst in a 24-year-old female patient without prior surgery or known trauma. Mainstay of treatment involves surgical resection, although less invasive treatments have been described. Prognosis depends on the origin of the cyst.
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8
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Adrenal Lymphangioma Masquerading as a Catecholamine Producing Tumor. Case Rep Endocrinol 2015; 2015:380151. [PMID: 26618011 PMCID: PMC4651645 DOI: 10.1155/2015/380151] [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: 08/06/2015] [Accepted: 10/21/2015] [Indexed: 11/18/2022] Open
Abstract
Objective. To report the unusual case of an adrenal lymphangioma presenting in a patient
with an adrenal cystic lesion and biochemical testing concerning for pheochromocytoma. The pertinent diagnostic and imaging features of adrenal lymphangiomas are reviewed. Methods. We describe a 59-year-old patient who presented with hyperhidrosis and a 2.2 by 2.2 cm left adrenal nodule. Biochemical evaluation revealed elevated plasma-free normetanephrine, urine normetanephrine, urine vanillylmandelic acid, and urine norepinephrine levels. Elevated plasma norepinephrine levels were not suppressed appropriately with clonidine administration. Results. Given persistent concern for pheochromocytoma, the patient underwent adrenalectomy. The final pathology was consistent with adrenal lymphangioma. Conclusions. Lymphangiomas are benign vascular lesions that can very rarely occur in the adrenal gland. Imaging findings are generally consistent with a cyst but are nonspecific. Excluding malignancy in patients presenting with adrenal cysts can be difficult. Despite its benign nature, the diagnosis of adrenal lymphangioma may ultimately require pathology.
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Hong IT, Cha JM, Lee JI, Joo KR, Baek IH, Shin HP, Jeon JW, Lim JU. [A Case of Cavernous Lymphangioma of the Small Bowel Mesentery]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2015; 66:172-5. [PMID: 26387702 DOI: 10.4166/kjg.2015.66.3.172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Lymphangioma is a benign vascular lesion with characteristics of subepithelial tumor which can proliferate in the lymphatic system. Lymphangioma of the small-bowel mesentery is rare, having been reported in less than 2% of all lymphangiomas. Lymphangioma does not require any specific treatment because it is absolutely a benign tumor. However, surgical exploration is rarely required for cases with disease-related symptoms or complications, or for those misdiagnosed as a malignant lesion. We recently experienced a case of mesenteric cavernous lymphangomas in a 53-year-old female who was misdiagnosed as having a liposarcoma. The final diagnosis was confirmed by a pathologic examination of the specimen that was obtained via laparoscopic exploration. Herein, we report a very rare case of mesenteric cavernous lymphangioma along with a brief review of relevant literature.
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Affiliation(s)
- In Taik Hong
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae Myung Cha
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Joung Il Lee
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Kwang Ro Joo
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Il Hyun Baek
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Hyun Phil Shin
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jung Won Jeon
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jun Uk Lim
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
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Gigantic lymphangioma with marked extraluminal progression of the ascending colon: report of a case. Surg Today 2014; 45:919-23. [PMID: 25344823 DOI: 10.1007/s00595-014-1055-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 04/30/2014] [Indexed: 10/24/2022]
Abstract
We report a case of gigantic cystic lymphangioma of the ascending colon excised through an open laparotomy. A 34-year-old woman consulted a gynecologist for treatment of infertility. Transvaginal ultrasonography revealed a cystic mass in the pelvis, and she was transferred to our hospital for further investigation. Abdominal enhanced computed tomography (CT) showed a bulky cystic mass, 25 cm or larger, in the abdominal and pelvic cavity. Colonoscopy revealed a cystic submucosal tumor with a cushion sign. Cystic lymphangioma was diagnosed and excised via open surgery as we could not exclude its malignant potential. Pathological examination confirmed lymphangioma. To our knowledge, this is the most gigantic lymphangioma of the colon documented in the literature. About 3 months after surgery, the patient discovered that she was pregnant and her first baby was delivered at term, uneventfully.
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Raherinantenaina F, Andriamampionona TF, Raoelijaona L, Randrianirina H, Mamin'ny Aina Rajaonanahary T, Nirina Rakoto Ratsimba H. [Cystic lymphangioma of the ascending mesocolon]. Presse Med 2014; 43:1296-8. [PMID: 24935682 DOI: 10.1016/j.lpm.2014.02.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 01/25/2014] [Accepted: 02/17/2014] [Indexed: 11/18/2022] Open
Affiliation(s)
- Fanomezantsoa Raherinantenaina
- Centre hospitalier universitaire Joseph-Ravoahangy-Andrianavalona (CHUJRA), service de chirurgie générale et vasculaire, BP 4150, Antananarivo, Madagascar.
| | | | | | - Hery Randrianirina
- CHUJRA, service de réanimation chirurgicale, BP 4150, Antananarivo, Madagascar
| | - Toky Mamin'ny Aina Rajaonanahary
- Centre hospitalier universitaire Joseph-Ravoahangy-Andrianavalona (CHUJRA), service de chirurgie générale et vasculaire, BP 4150, Antananarivo, Madagascar
| | - Hery Nirina Rakoto Ratsimba
- Centre hospitalier universitaire Joseph-Ravoahangy-Andrianavalona (CHUJRA), service de chirurgie générale et vasculaire, BP 4150, Antananarivo, Madagascar
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12
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Oui H, Lamm C, Stiver S, Williams B, Kwon SY, Bae Y, Jeon S, Park S, Min JJ, Choi J. Congenital lymphangiomatosis and an enteric duplication cyst in a young dog. J Small Anim Pract 2014; 55:379-82. [PMID: 24628429 DOI: 10.1111/jsap.12208] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2014] [Indexed: 01/07/2023]
Abstract
A two-year-old female poodle with abdominal distention was diagnosed with concurrent enteric duplication cyst and lymphangiomatosis. Both lesions were shown as cystic structures, but some characteristic features of enteric duplication cyst were identified including a thick cyst wall and shared blood supply with the duodenum. Although it was challenging to discriminate between the types of cyst based on diagnostic imaging, this report describes the characteristics of each type of lesion using several different imaging modalities.
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Affiliation(s)
- H Oui
- College of Veterinary Medicine, Chonnam National University, Gwangju, 500-757, South Korea
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Makni A, Chebbi F, Fetirich F, Ksantini R, Bedioui H, Jouini M, Kacem M, Ben Safta Z. Surgical management of intra-abdominal cystic lymphangioma. Report of 20 cases. World J Surg 2012; 36:1037-1043. [PMID: 22358782 DOI: 10.1007/s00268-012-1515-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cystic lymphangioma (CL) is a benign rare malformation of lymphatic vessels. Its discovery in adults is rare. Although it can affect any organ, the common forms found in adults are mesenteric and/or retroperitoneal CL. This article was designed to study the epidemiological, diagnostic difficulties, and therapeutic principles of intra-abdominal cystic lymphangioma in adults. METHODS We report a retrospective study from January 1998 to September 2010 concerning 20 patients who underwent surgical removal of a CL. We were interested in discovering the clinical, biological, and radiological characteristics of CL. The localization, size, and number of cysts have been reported, as well as the surgical intervention used and the postoperative immediate and late complications. RESULTS The median age was 46 years. Abdominal pain was the main symptom and was found in 15 patients (75%). Physical examination revealed an abdominal mass in 12 patients (60%). In four patients (20%), the cystic lymphangioma was incidental. Abdominal ultrasound and abdominal CT scan helped to highlight 22 cystic masses. CL diagnosis was established preoperatively in 13 patients (65%). Six patients (30%) were operated with a diagnosis other than CL. The diagnosis was made intraoperatively in one case (5%). Only two patients (10%) were operated on in emergency: one due to an infected CL and the other was CL complicated with intracystic hemorrhage. A laparotomy in 13 cases (65%) was the surgical approach used, whereas 7 cases (35%) benefited from a laparoscopy. No conversion was noted. The majority of the patients, 18 cases (90%), received a total cystectomy. Only two patients (10%) had recurrences of which only one was reoperated. CONCLUSIONS The diagnosis of CL often is facilitated by means of modern imaging; however, other diagnoses may be discussed, particularly hydatid disease endemic areas. If symptomatic lesions or complications arise, complete surgical excision, when possible without major sacrifice, seems to be the best therapeutic option to reduce the risk of recurrence.
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Affiliation(s)
- Amin Makni
- Department of General Surgery 'A', La Rabta Hospital, Jabbari, 1007, Tunis, Tunisia.
| | - Faouzi Chebbi
- Department of General Surgery 'A', La Rabta Hospital, Jabbari, 1007, Tunis, Tunisia
| | - Fadhel Fetirich
- Department of General Surgery 'A', La Rabta Hospital, Jabbari, 1007, Tunis, Tunisia
| | - Rachid Ksantini
- Department of General Surgery 'A', La Rabta Hospital, Jabbari, 1007, Tunis, Tunisia
| | - Heykal Bedioui
- Department of General Surgery 'A', La Rabta Hospital, Jabbari, 1007, Tunis, Tunisia
| | - Mohamed Jouini
- Department of General Surgery 'A', La Rabta Hospital, Jabbari, 1007, Tunis, Tunisia
| | - Montassar Kacem
- Department of General Surgery 'A', La Rabta Hospital, Jabbari, 1007, Tunis, Tunisia
| | - Zoubeir Ben Safta
- Department of General Surgery 'A', La Rabta Hospital, Jabbari, 1007, Tunis, Tunisia
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Chiappinelli A, Forgues D, Galifer RB. Congenital abdominal cystic lymphangiomas: what is the correct management? J Matern Fetal Neonatal Med 2011; 25:915-9. [DOI: 10.3109/14767058.2011.600364] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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15
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Na WT, Lee TH, Lee BS, Kim SH, Chae HB, Kim SB, Kim YS, Kim SM, Im EH, Huh KC, Choi YW, Kang YW. [Clinical aspects of intraabdominal cystic lymphangioma in Korea]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2011; 56:353-8. [PMID: 21173558 DOI: 10.4166/kjg.2010.56.6.353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND/AIMS cystic lymphangioma is an uncommon disease, and rarely develops in the intraabdomen. The aim of this article was to discuss about clinical characteristics of intraabdominal cystic lymphangioma developed in Korea. METHODS age, sex, symptoms, locations and size of the lesions, diagnostic methods, treatments, complications and recurrence were analyzed in 13 pathologically confirmed cases of intraabdominal cystic lymphangioma and 18 cases of literature consideration reported in Korea. RESULTS intraabdominal cystic lymphangioma commonly developed in adults compared to the other lymphangioma, and frequently located in the mesentery. Abdominal pain was the most common symptom, but it was a non-specific finding. Tenderness and abdominal mass were not significantly associated. The size of mass was diverse. Abdominal ultrasonography and abdominal CT were diagnostic tools most commonly used, but preoperative diagnosis was possible only in 22.6%. All patients were discharged without any complications, and no recurrence was reported. CONCLUSIONS preoperative diagnosis of intraabdominal cystic lymphangioma is difficult and symptoms and signs are not specific. Intraabdominal cystic lymphangioma should be suspected in patients with non specific abdominal pain and intraabdominal mass and active diagnostic evaluation is mandatory.
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Affiliation(s)
- Woon Tae Na
- Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea
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Leland HA, Lee JT, Tan JH, Romine LE, Bansal V. Cystic lymphangioma of the lesser curvature of the stomach--case report. J Radiol Case Rep 2011; 5:31-7. [PMID: 22470794 PMCID: PMC3303445 DOI: 10.3941/jrcr.v5i5.716] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We report a case of a cystic lymphangioma arising from the lesser curvature of the stomach in a 16-year-old female who initially presented with abdominal pain, nausea, and emesis. Contrast enhanced computed tomography and magnetic resonance imaging revealed a large, thin-walled multicystic mass located anteromedial to the stomach, which was predominately supplied by the left gastric artery. Given the imaging appearance and location, a mesenteric cyst, specifically a cystic lymphangioma, was considered. Lymphangioma was the final pathological diagnosis after laparotomy with complete resection of the cystic abdominal mass.
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Affiliation(s)
- Hyuma A. Leland
- Department of Surgery, UCSD Medical Center, San Diego, CA, USA
| | - James T. Lee
- Department of Radiology, UCSD Medical Center, San Diego, CA, USA
| | - Justin H. Tan
- Department of Radiology, UCSD Medical Center, San Diego, CA, USA
| | - Lorene E. Romine
- Department of Radiology, UCSD Medical Center, San Diego, CA, USA
| | - Vishal Bansal
- Department of Surgery, UCSD Medical Center, San Diego, CA, USA
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Hwang SS, Choi HJ, Park SY. Cavernous mesenteric lymphangiomatosis mimicking metastasis in a patient with rectal cancer: A case report. World J Gastroenterol 2009; 15:3947-9. [PMID: 19701979 PMCID: PMC2731261 DOI: 10.3748/wjg.15.3947] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [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 usually occurs in children and usually involves the skin. Mesenteric lymphangioma is extremely rare in adults. Typically, lymphangioma appears on computed tomography (CT) as a lower attenuation of a cystic mass, however, some cases appear to be a solid mass. We describe the CT and 18F-FDG positron emission tomography/CT appearance in a case of jejunal and mesenteric cavernous lymphangiomatosis mimicking metastasis in an adult patient with rectal cancer.
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Parakh A, Dubey AP, Garg A, Khurana N, Aggarwal SK. Cystic lymphangiomatous hamartoma masquerading as massive ascites. Indian J Pediatr 2009; 76:753-4. [PMID: 19475359 DOI: 10.1007/s12098-009-0141-y] [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: 04/23/2008] [Accepted: 07/24/2008] [Indexed: 10/20/2022]
Abstract
We report a 4-year-old boy presenting with a tense massive ascites and large hydrocele. History and physical examination were unremarkable. Routine laboratory studies were normal. Abdominal ultrasonography revealed massive ascites. Contrast CT was suggestive of a large cyst covering the entire peritoneal cavity. At laparotomy, a large cystic tumor was found extending into the scrotum through the left inguinal ring. Histopathologic examination diagnosed the tumor as a cystic lymphangiomatous hemartoma. Although abdominal lymphangiomas are seen in children, but presenting as massive ascites with hydrocele is very rare.
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Affiliation(s)
- Ankit Parakh
- Department of Pediatric, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India.
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Bezzola T, Bühler L, Chardot C, Morel P. Le traitement chirurgical du lymphangiome kystique abdominal chez l’adulte et chez l’enfant. ACTA ACUST UNITED AC 2008; 145:238-43. [DOI: 10.1016/s0021-7697(08)73752-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kim JK, Yoo KS, Moon JH, Park KH, Chung YW, Kim KO, Park CH, Hahn T, Park SH, Kim JH, Jeon JY, Kim MJ, Min KS, Park CK. Gallbladder lymphangioma: A case report and review of the literature. World J Gastroenterol 2007; 13:320-3. [PMID: 17226918 PMCID: PMC4065967 DOI: 10.3748/wjg.v13.i2.320] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Lymphangiomas are rare, benign tumors of the lymphatic system, usually present in children aged 5 years and younger. Because they are asymptomatic until the mass enlarges to cause symptoms, most lymphangiomas are diagnosed at adulthood incidentally. We experienced a case of a 60-year-old man diagnosed with a cystic lymphangioma of the gallbladder, which was successfully resected without any complication. Magnetic resonance imaging and magnetic resonance cholangiopancreatography were very helpful for the diagnosis of the cystic lesion around the gallbladder as were ultrasonography and computed tomography scan. These showed a multi-lobulated cystic mass with intact cystic duct and bile duct in the gallbladder fossa. The patient underwent an open cholecystectomy and the histological findings were consistent with a cystic lymphangioma of the gallbladder. We here report the case of cystic lymphangioma of the gallbladder with a review of the literature.
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Affiliation(s)
- Jwa-Kyung Kim
- Department of Gastroenterology and Hepatology, Hallym University Sacred Heart Hospital, 896 Pyeongchon-dong, Dongan-gu, Anyang, Gyeonggi 431-070, Korea
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Kayser C, Kayser G, Baier P, Hopt UT, Eggstein S. Surgery for cystic lymphangioma in Gorlin–Goltz syndrome. Langenbecks Arch Surg 2007; 392:203-7. [PMID: 17221269 DOI: 10.1007/s00423-006-0126-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2006] [Accepted: 11/03/2006] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We present a case of three major lymphomesenteric cysts in a female patient with known basal cell nevus syndrome (BCNS or Gorlin-Goltz syndrome). DISCUSSION Although those cysts have been reported to appear in this syndrome, the exact prevalence is not known. In this case, the patient suffered from severe and recurrent abdominal pain due to bowel obstruction. CONCLUSION By causing severe symptoms, cystic lymphangiomas are an important complication of the BCNS despite of their seldom occurrence. Surgeons confronted with intraabdominal masses in a patient with BCNS should always be aware of this manifestation of the disorder and plan interdisciplinary operations.
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Affiliation(s)
- C Kayser
- Department of General Surgery, Freiburg University Hospital, Hugstetter Strasse 55, 79106, Freiburg, Germany.
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de Lagausie P, Bonnard A, Berrebi D, Lepretre O, Statopoulos L, Delarue A, Guys JM. Abdominal lymphangiomas in children: interest of the laparoscopic approach. Surg Endosc 2006; 21:1153-7. [PMID: 17177082 DOI: 10.1007/s00464-006-9091-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2006] [Revised: 07/11/2006] [Accepted: 08/02/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Lymphangiomas are rare benign lesions of the lymphatic system. The most common symptoms are abdominal tumor or "acute abdomen" in children. The treatment of choice is complete surgical resection, but the recurrence rate with incomplete resection is high, and laparotomy exposes the patient to adhesions. The authors report their experience with the lymphangioma laparoscopic approach. METHODS This retrospective study examined 15 consecutive operations for lymphangiomas in children, ages 5 months to 14 years, treated during the 5-year period from 1999 to 2004. RESULTS Six patients were treated using the primary laparotomy approach, and nine patients underwent the laparoscopic procedure, six successfully. Three conversions were necessary (1 case requiring partial colectomy, 1 retroperitoneal case with adherence on the aorta and vena cava, 1 case with partial volvulus). Morbidity included two cases of acute occlusion caused by adhesions after laparotomy. There was no recurrence of lymphangioma during a mean follow-up period of 35 months. CONCLUSION The laparoscopy procedure could be used successfully for abdominal lymphangioma, even in an emergency. When the laparoscopic resection is impossible, laparotomy or sclerotherapy can be discussed.
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Affiliation(s)
- P de Lagausie
- Service de Chirurgie Pédiatrique, Hôpital d'Enfant la Timone, 264 rue Saint Pierre, 13005, Marseille, France.
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Allen JG, Riall TS, Cameron JL, Askin FB, Hruban RH, Campbell KA. Abdominal lymphangiomas in adults. J Gastrointest Surg 2006; 10:746-51. [PMID: 16713549 DOI: 10.1016/j.gassur.2005.10.015] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2004] [Accepted: 10/19/2005] [Indexed: 01/31/2023]
Abstract
Abdominal lymphangiomas are rare benign cystic tumors that can become locally invasive and often require resection. They arise in all ages and have a variable presentation. We performed a retrospective review of a single institution surgical experience with this lesion in adults. The pathology prospective database was reviewed to identify patients with surgically resected abdominal lymphangiomas from January 1986 to May 2004. Retrospective review and follow-up was performed for each patient. The six patients with abdominal lymphangiomas ranged in age from 38 to 66 years. They presented with a variety of signs and symptoms. All underwent CT scan that demonstrated a cystic lesion, but in only one third was the diagnosis made preoperatively. Tumors were located in the retroperitoneum, small bowel mesentery, liver, and pancreas. Five of the six tumors were completely resected. Two of the six required resection of adjacent or involved organs. Follow-up ranged between 6 months and 18 years. All had symptomatic relief after resection, and no patient showed evidence of recurrence in this time period. Abdominal lymphangiomas are rare. The correct diagnosis often remains elusive until tissue is obtained. The treatment of choice is complete surgical resection. When completely resected, these lesions seem not to recur, and the overall prognosis is excellent.
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Affiliation(s)
- J Geoff Allen
- Department of Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA
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Affiliation(s)
- Thomas Saers
- Department of Medicine, Merheim City Hospital, Teaching Hospital of Cologne University, 51109 Cologne, Germany
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Mabrut JY, Grandjean JP, Henry L, Chappuis JP, Partensky C, Barth X, Tissot E. [IMesenteric and mesocolic cystic lymphangiomas. Diagnostic and therapeutic management]. ANNALES DE CHIRURGIE 2002; 127:343-9. [PMID: 12094416 DOI: 10.1016/s0003-3944(02)00770-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
STUDY AIM Study of clinical, diagnostic and therapeutic aspects of mesenteric and mesocolic cystic lymphangiomas. MATERIAL AND METHODS 15 cases were retrospectively analysed: 5 adults (mean age 36.8 years, range 26 to 46) and 10 children (mean age 23 months, range 0 to 5 years). Diagnosis was prenatal in 1 case. Symptoms were: abdominal pain (80%), fever (20%), abdominal mass (46%), occlusive syndrome (33%), chylous ascitis 1 case. Tumours were mesenteric (86%) or mesocolic (13%). RESULTS Complete resection was performed in 11 cases (including 10 bowel resections), incomplete resections in 3 and doxycycline sclerotherapy once. Mean follow-up is 5 years. One recurrence occurred 6 years after complete resection and 1 tumour increased after incomplete resection. Patient treated by sclerotherapy was non symptomatic with a 3.5 years follow-up after last injection. CONCLUSION Mesenteric and mesocolic cystic lymphangiomas are congenital benign tumours. Complete resection should be performed whenever possible. Intracystic sclerotherapy with doxycyclin is possible for unresectable lymphangiomas.
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Affiliation(s)
- J Y Mabrut
- Service de chirurgie générale, digestive et de transplantation hépatique, hôpital de la Croix-Rousse, 103, Grande-rue-de-la-Croix-Rousse, 69317 Lyon 04, France.
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Hauser H, Mischinger HJ, Beham A, Berger A, Cerwenka H, Razmara J, Fruhwirth H, Werkgartner G. Cystic retroperitoneal lymphangiomas in adults. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 1997; 23:322-6. [PMID: 9315061 DOI: 10.1016/s0748-7983(97)90777-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Lymphangioma (LA) is a rare benign tumour of the lymphatic tissue, most common in the neck and head, and clinically manifests itself mostly in childhood. Within this group, intra-abdominal and retroperitonal LA are the rarest tumours, especially when occurring in adults. We report four LAs localized in the retroperitoneum of patients aged between 28 and 72 years. One of these tumours infiltrated the transverse mesocolon and greater omentum, others were situated in the left retroperitoneum and retroperitoneally at the duodeno-jejunal flexure, and in the retrosplenal and retropancreatic area. Diagnosis was made by light microscopy supported by immunohistochemistry. In three cases the tumour could be removed by radical surgery and none of these patients had a recurrence (median follow-up time: 4 years). The tumour could not be removed completely from one patient with pre-operative chylascos. Six months after diagnosis of LA this patient died of cardiopulmonary failure due to progressive tumour chylascos. Isolation and ligation of the cystic LA's peduncle as well as ligation of lymph channels can prevent recurrences and chylascos.
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Affiliation(s)
- H Hauser
- Department of Surgery, Karl Franzens University, Graz, Austria
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