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Zeng Z, Liao H, Hu F, Zhao F, Liu H, Hu Q, Yu H. Outcome of Sclerotherapy in a Preterm Infant with a Giant Fetal Neck Lymphatic Malformation: A Case Report. Int J Womens Health 2023; 15:1771-1778. [PMID: 38020936 PMCID: PMC10656836 DOI: 10.2147/ijwh.s430858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Lymphatic malformation (LM), most commonly present in the neck area, is benign vascular malformations of the lymphatic system. In an infant, however, LM poses a high risk of adverse outcomes. Case Presentation We present a case with a giant fetal LM. Through ultrasonography, at 23+ weeks of gestation, a septate cystic mass 7.2×6.5×6.3 cm in size was found on the right side of the fetus's neck. After extensive counseling by the multidisciplinary team, the parents chose to continue the pregnancy. Severe fetal tracheal compression was observed at 29 weeks by magnetic resonance imaging (MRI). At 31 weeks and 5 days, owing to suspected fetal distress, an emergency cesarean section was performed and a male baby weighing 1720 g was delivered. The mass was 10×16×8 cm in size and ex utero intrapartum treatment (EXIT) was implemented. Due to progressive growth of the mass secondary to intralesional bleeding, an intralesional injection of bleomycin was administered three days later. This injection was repeated at the age of 1 month and 8 days. The baby was followed up and, by a year after his birth, LM had disappeared. The baby has since been in good health. Conclusion Accurate prenatal diagnosis and regular monitoring of a fetus with LM may improve prognosis. It is essential to have a trained multidisciplinary team to evaluate the condition of the fetus and the neonate and to provide treatment based on the evaluation. Our experience with intralesional bleomycin injection for the treatment of a giant fetal neck LM in a preterm infant had a favorable outcome. Long-term follow-up by a multidisciplinary team is needed in such cases.
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Affiliation(s)
- Zhaomin Zeng
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People’s Republic of China
| | - Hua Liao
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People’s Republic of China
| | - Fan Hu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People’s Republic of China
- Department of Paediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Fumin Zhao
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People’s Republic of China
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Hongyan Liu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People’s Republic of China
| | - Qing Hu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People’s Republic of China
| | - Haiyan Yu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People’s Republic of China
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Cystic Hygroma in a Dental Hygienist Reporting With Carpal Tunnel Syndrome: A Case Report. J Chiropr Med 2021; 20:30-36. [PMID: 34025303 DOI: 10.1016/j.jcm.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 12/29/2019] [Accepted: 01/27/2021] [Indexed: 11/23/2022] Open
Abstract
Objective This purpose of this case report is to describe the chiropractic management of a patient who presented with symptoms of hand neuropathy. Clinical Features A 35-year-old woman presented with a 6-month history of numbness and tingling in the first and second digits of the right hand. Visual inspection revealed a large golf ball-like mass in the patient's right lower neck region. Orthopedic assessment revealed a Tinel's sign at the right carpal tunnel, positive Allen's maneuver, present flick sign, and diminished right radial pulse strength. Advanced diagnostic imaging had been taken previously at the ages of 11 and 24 years, and showed the presence of cystic hygroma in the patient's right axilla and lower neck region. Intervention and Outcome The patient was treated using manipulative therapy to the thoracic spine, myofascial release therapy, and therapeutic ultrasound over the right carpal tunnel. Active home care included postural relief exercises and education about work-related ergonomics. Several functional and subjective improvements were seen within the first 2 weeks of treatment. Symptoms of right-hand numbness resolved after 8 treatments. Conclusion In this case, the chiropractor originally thought the patient's hand numbness was due to a cystic hygroma; however, this was later considered an incidental finding. The patient's symptoms seemed to respond to chiropractic management and reduced within 1 month.
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Tica OS, Gug C, Tica AA, Busuioc CJ, Amiri S, Tica I, Bică Brăiloiu G, Tica VI. A unique case of recurrent fetal cystic hygroma: first fetus with an inherited heteromorphism of chromosome 1 (1qh+) and the second fetus with 69XXX triploidy. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2021; 61:935-940. [PMID: 33817737 PMCID: PMC8112748 DOI: 10.47162/rjme.61.3.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The authors report a unique recurrent septated cystic hygroma (CH), on two successive pregnancies, at five years interval. The chromosome analysis of the first fetus showed an increase in length of heterochromatin on the long arm of chromosome 1 – 1qh+, a chromosomal polymorphism inherited from mother, 46XX,1qh+,14ps+,21ps+. The karyotype of the second CH, with more severe ultrasound (US) imaging, showed a 69XXX triploidy. The patient took no risk and underwent each time a termination of pregnancy (TOP). The first karyotype is generally considered “normal”, although there are few reports linking 1qh+ with low fertility, but this was not the case, the patient having, from a previous marriage, a healthy boy and two TOPs. So, this “particular”, but “healthy” karyotype was not a cause for the first CH. The second karyotype highlights a possible causality between the 69XXX triploidy, usually associated with partial hydatidiform mole, and a more severe septated CH in the last fetus. Neither the CHs’ appearance nor their recurrence seemed to be family linked, as the two CHs had distinct genetic profiles. We recommend that, once CH is diagnosed, a careful US examination is compulsory for the determination of subcutaneous edema, ascites, pleural and pericardial effusions and cardiac or renal abnormalities; an early genetic work-up is mandatory, by chorionic villus sampling or amniocentesis. However, a “healthy” karyotype does not exclude a severe form, as in our first case of CH. Due to the very poor outcome of fetuses with CH, the patient must be thoroughly informed about the short and the long-term fetal prognosis.
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Affiliation(s)
- Oana Sorina Tica
- Department of Pharmacology, University of Medicine and Pharmacy of Craiova, Romania; ; Department of Internal Medicine, Faculty of Medicine, Ovidius University of Constanţa, Romania;
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Hosokawa T, Tanami Y, Sato Y, Ishimaru T, Kawashima H, Oguma E. Comparison of sonographic findings between neonates with pyriform sinus fistulas and lymphangiomas. Am J Otolaryngol 2021; 42:102783. [PMID: 33125899 DOI: 10.1016/j.amjoto.2020.102783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/17/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE In neonates, pyriform sinus fistulas and lymphangiomas require different early treatment, such as surgical resection or sclerosing therapy, respectively. We aimed to evaluate the use of sonographic findings for differentiating between pyriform sinus fistulas and lymphangiomas in neonates with a lateral cervical cystic mass. METHODS Sixteen cases diagnosed with pyriform sinus fistulas (n = 7) or lymphangiomas (n = 9) were included. Sonographic findings, including fistulas from the pyriform sinus, air-containing cysts, abnormal thyroid parenchyma echogenicity, internal septae within the cyst and spread to the opposite cervical site, were compared between neonates with pyriform sinus fistulas and those with lymphangiomas. Fisher's exact was used for statistical comparisons. RESULTS A significant difference was observed between cases with and without air-containing cysts (present/absent in neonate with pyriform sinus fistula vs lymphangioma: 5/2 vs. 0/9; p = 0.005), abnormal thyroid parenchyma echogenicity (present/absent: 4/3 vs. 0/9; p = 0.019), and internal septae within the cysts (present/absent: 2/7 vs. 9/9; p = 0.005). No significant differences were observed between cases with or without a fistula from the pyriform sinus (present/absent: 2/5 vs. 9/0; p = 0.175) and spread to the opposite cervical site (present/absent: 4/3 vs. 4/5; p = 0.500). CONCLUSIONS Ultrasound can differentiate pyriform sinus fistulas from lymphangiomas in neonates. In our small cohort, if they exhibited the respective sonographic findings; fistula from pyriform sinus, air-containing cysts or abnormal thyroid parenchyma echogenicity, patients were diagnosed as cases of pyriform sinus fistula. These diagnoses are critical for pediatric surgeons or otolaryngologists in surgical planning.
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El Sayed M, Touny M, Ibrahim N, Kasb I, Al-Azzawi Z. A rare case of cystic hygroma in neck and extending into thoracic cavity. Int J Surg Case Rep 2020; 76:174-177. [PMID: 33038842 PMCID: PMC7550823 DOI: 10.1016/j.ijscr.2020.09.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/13/2020] [Accepted: 09/13/2020] [Indexed: 12/02/2022] Open
Abstract
Cystic Hygroma in Neck and Thorax. Multi disciplinary team approach in the treatment of neck and thorax cystic hygroma. Surgical management of huge cystic hygroma.
Introduction Cystic hygroma is a benign swelling of the neck among the pediatric population. It is a fluid-filled sac resulting from blockage in the lymphatic system and is commonly located in the cervical region and axilla. Case presentation We present a rare case of a large cystic hygroma in the neck and the thorax in a 12 year’s old male. The lesion was diagnosed with the help of MRI which showed a cystic lesion extending from the carotid sheath to the mediastinum. And confirmed by fine-needle aspiration cytology (FNAC). The lesion was treated by surgical excision along with a cardiothoracic team. Discussion We will explore in our discussion the diagnostic modalities for such lesions and the different treatments available for Cystic Hygromas. Conclusion We concluded from this case that accurate diagnosis and careful planning with multidisciplinary team approach and choosing the right treatment as indicated has a great impact on the results for such difficult cases.
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Affiliation(s)
- Mohamed El Sayed
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Benha University, Benha, Egypt; Department of Oral and Maxillofacial Surgery Nasser Institute Hospital, Cairo, Egypt
| | - Mohamed Touny
- Department of Oral and Maxillofacial Surgery Nasser Institute Hospital, Cairo, Egypt.
| | | | - Ibrahim Kasb
- Department of Cardiothoracic Surgery, Faculty of Medicine, Benha University, Benha, Egypt
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Wijaya Ramlan A, Ang M, Peddyandhari F. Airway obstruction after anesthesia in a 3-month-old baby with lymphangioma. BALI JOURNAL OF ANESTHESIOLOGY 2020. [DOI: 10.4103/bjoa.bjoa_31_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Souki BQ, Figueiredo DSF, Lima ILDA, Oliveira DD, Miguel JAM. Two-phase orthodontic treatment of a complex malocclusion: giving up efficiency in favor of effectiveness, quality of life, and functional rehabilitation? Am J Orthod Dentofacial Orthop 2013; 143:547-58. [PMID: 23561417 DOI: 10.1016/j.ajodo.2012.02.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 02/01/2012] [Accepted: 02/01/2012] [Indexed: 10/27/2022]
Abstract
The interceptive orthodontic treatment of patients with complex dentofacial abnormalities is frequently inefficient and produces less than ideal outcomes. Therefore, postponing therapy to a single-phase surgical-orthodontic approach might be considered a reasonable option. However, other relevant aspects of the patient's quality of life, such as possible psychosocial problems and functional impairments, should also be considered before deciding whether to intercept a severe dentofacial malocclusion while the patient is still growing, or wait and treat later. This case report describes the nonsurgical treatment of a young patient with a severe Class III open-bite malocclusion associated with a cervical cystic lymphangioma. Despite the poor interceptive therapy prognosis, a 2-phase approach was effective. A reflection about giving up efficiency in favor of effectiveness, functional rehabilitation, and the patient's quality of life is included.
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Affiliation(s)
- Bernardo Quiroga Souki
- Graduate Program in Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Han P, Huang X, Cai Q, Sun W, Liang F, Guo M, Jiang X. Endoscope-assisted excision of macrocystic lymphangioma in neck via anterior chest approach in infants and children. Int J Pediatr Otorhinolaryngol 2011; 75:1275-9. [PMID: 21802152 DOI: 10.1016/j.ijporl.2011.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Revised: 06/29/2011] [Accepted: 07/02/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Macrocystic lymphangioma of the neck is traditionally removed via an overlying incision near the mass. The resultant scar can be aesthetically displeasing, and endoscope-assistant surgery is still rarely used in pediatric subjects. So we report the endoscope-assisted excision of the macrocystic lymphangioma via anterior chest, and explore its feasibility, validity and security. METHODS From June 2005 to December 2008, 6 infants and children with macrocystic lymphangioma accepted endoscope-assisted excision via anterior chest approach. RESULTS All procedures were successfully performed using the endoscope-assisted approach. There were no conversions of the operations or postoperative complications. All patients and their parents were satisfied with the cosmetic results. CONCLUSIONS Endoscope-assisted excision of the macrocystic lymphangioma via anterior chest approach in children can be applied effectively, safely and feasibly, allowing adequate exposure for dissection, and resulting in a good cosmetic result, and it would be considered as a new surgical approach for these patients.
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Affiliation(s)
- Ping Han
- Department of Otolaryngology, Head and Neck Surgery, the Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, PR China
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Koo KY, Lee JS, Lee SM, Park MS, Namgung R, Park KI, Lee C, Yoon CS, Jung WH, Choi HS. A case of postoperative nasopharyngeal reflux associated with retropharyngeal lymphangioma in newborn infant. KOREAN JOURNAL OF PEDIATRICS 2010. [DOI: 10.3345/kjp.2010.53.2.258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kyo Yeon Koo
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Seok Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Min Soo Park
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Ran Namgung
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Kook In Park
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Chul Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Choon Sik Yoon
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Woo Hee Jung
- Department of Clinical Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Hong Shik Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
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Literature Watch. Lymphat Res Biol 2009. [DOI: 10.1089/lrb.2009.7203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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