Intra-abdominal cystic lymphangioma of the mesocolon sigmoids: a rare entity in adult patient woman

A rare case of huge intra-abdominal cystic lymphangioma arising from rectovesical pouch; a case report

INTRODUCTION AND IMPORTANCE

Lymphangiomas are benign maldevelopment of the lymphatic vessels; they classically occur in the head and neck region. They are usually seen in newborn and pediatric age groups, especially below two years of age, and rarely occur in adults.

PRESENTATION OF CASE

A 27-year-old male patient presented with progressive abdominal swelling of two-year duration. He had also difficulty breathing from the mass effect of a huge intra-abdominal mass. He was emaciated; vital signs were in the normal range, except for tachypnea. His abdomen was hugely distended, tense, dull to percussion, and the umbilicus was everted. CT scan revealed a multiseptated cystic mass. He underwent complete surgical excision with ligation of the cyst peduncle. The diagnosis of cystic lymphangioma was confirmed after a histopathologic examination.

CLINICAL DISCUSSION

Lymphangiomas have an incidence rate of one in every 20,000 to 250,000 populations. The clinical presentation of abdominal cystic lymphangioma is non-specific and is related to the size, and location of the tumor. The preoperative diagnosis of abdominal cystic lymphangioma is often challenging and leads to misdiagnosis. The management of abdominal cystic lymphangioma depends on the mode of presentation and location of the tumor. It has good prognosis after complete surgical resection of the tumor.

CONCLUSION

Abdominal cystic lymphangioma arising from the rectovesical pouch is a very rare condition. The best management is complete surgical resection to prevent a recurrence. Despite, the rarity of the disease in adults they should be considered as a differential diagnosis in cystic abdominal tumors.

Review of diagnosis, differential diagnosis, and management of retroperitoneal lymphangioma

Lymphatic malformation (LM) is the currently preferred term for what was previously known as lymphangioma. Retroperitoneal LMs are extremely rare, benign, cystic masses that arise from lymphatic vessels. They can be challenging to diagnose because they resemble other retroperitoneal cystic tumors. The development of treatment strategies for rare diseases, including retroperitoneal LM, requires the acquisition of new knowledge to enhance our understanding of the disease progression. Therefore, we present an update regarding fundamental and advanced issues associated with retroperitoneal LM. This review describes the epidemiology, histopathology, biomedicine, clinical manifestations, radiological features, differential diagnosis, and management of this lesion.

Case report: A mesocolic lymphangioma in a 14-year-old child resected by laparoscopic surgery

INTRODUCTION

Cystic lymphangioma is a benign malformation tumor of the lymphatic system. Its location is variable, and mesocolic localization remains extremely rare.

CASE PRESENTATION

We report a case of right mesocolon giant cystic lymphangioma in a previously healthy 14-year-old boy who was successfully managed through a minimally invasive laparoscopic excision. The patient presented with 8 months of dull abdominal pain, sporadic, located on the peri-umbilicus, exacerbated for a month. An abdominal computed tomography (CT) revealed a large, multiseptated cystic mass on the right mesocolon. Right mesocolic excision using a laparoscope was performed on this patient. He was discharged on the fifth day without complications. Recurrence was not detected in three months of follow-up.

CONCLUSION

Cystic lymphangiomas in the mesocolon are rare benign neoplasms that pose diagnostic challenges. Complete resection is the optimal option for diagnostic confirmation and recurrence prevention. Laparoscopic surgery is feasible for children with mesocolic lymphangioma.