Case report and literature review: Giant retroperitoneal cystic lymphangioma

Laparoscopic surgery for giant retroperitoneal lymphangioma: a case report

This case report describes a 66-year-old male diagnosed with a giant retroperitoneal lymphangioma, presenting with an abdominal mass confirmed via magnetic resonance imaging (MRI). Laparoscopic surgery was successfully performed to excise the mass, with histopathological examination confirming the diagnosis. The patient's postoperative recovery was uneventful, with no signs of recurrence or metastasis observed at the three-month follow-up. This case underscores the feasibility and advantages of utilizing laparoscopic techniques in the management of large retroperitoneal lymphangiomas.

Cystic Lymphangioma of the Mesentery in an Adult: A Case Report and Literature Review

Lymphangiomas are rare benign cystic tumors. Surgical excision is the primary treatment, aiming for complete removal. Diagnosis relies on imaging and histological confirmation. Malignant transformation is exceptionally rare. We report a 25-year-old man admitted for peri-umbilical abdominal pain and an abdominal mass. Imaging revealed multilocular peritoneal cystic formations with infiltration of adjacent mesenteric fat. Laboratory findings were unremarkable, and exploratory laparotomy was performed. A voluminous cystic mass originating from the mesentery was discovered, requiring intestinal sacrifice for complete resection. Immediate postoperative recovery was smooth. Pathological analysis confirmed the diagnosis of mesenteric cystic lymphangioma. The patient had a favorable outcome with no tumor recurrence at a three-year follow-up. We emphasize the significance of complete surgical removal to prevent complications associated with cystic lymphangioma and reduce the risk of recurrence.

Axillary Cystic Lymphangioma in an Adult: A Case Report

Lymphangioma is a congenital malformation of the lymphatic system most often reported in children. Its occurrence in adults is rare. It usually develops in the head, neck, and axillary region. It mimics other conditions, such as cold abscess, simple cyst, hydatid cyst, and hemangioma, on clinical examination. Here, we report a case of cystic lymphangioma in the axillary region of a 32-year-old male. The patient underwent surgical excision and histopathology confirmed cystic lymphangioma. Although it is very rare in adults, cystic lymphangioma should be considered in the differential diagnosis of an axillary mass.

Imaging Findings and Misdiagnosis of Bronchogenic Cysts: A Study of 83 Cases

Objective

We characterize computed tomography (CT) and magnetic resonance imaging (MRI) features of bronchogenic cysts (BCs) and analyze misdiagnosis.

Methods

The retrospective study consisted of 83 patients with BCs. CT and MRI images were assessed for mass location, maximum diameter, density, calcification, signal intensity, and enhancement pattern. Eighty-three patients underwent plain CT in which 53 underwent enhanced CT. Thirteen patients received both plain and enhanced MR, and only one received just a plain MR.

Results

Eighty-three masses were all solitary, with 71 having a roundish morphology, and twelve having a lobulated or irregular morphology. Sixty-six masses are mediastinal type, four are intrapulmonary type, and 13 are ectopic type. Calcification occurred in 14 lesions. On plain CT, 13 lesions displayed water-like attenuation (-20-20 Hu), and 70 showed soft-tissue attenuation (≥21 Hu). On T1WI, eight masses were hyperintense, three were isointense, and three were hypointense. Fourteen masses were hyperintense on T2WI and (Apparent Diffusion Coefficient) ADC sequence. On (Diffusion Weighted Imaging) DWI, six masses were hypointense and eight were hyperintense. Enhanced T1WI showed seven cases were unenhanced, while six were marginally enhanced. Twenty cases were misdiagnosed as thymomas, eleven as neurogenic tumors, six as lymphangiomas, and two as lung cancer. Five cases were misdiagnosed as other diseases. Patients with BCs underwent MR (42.9%) had a lower rate of misdiagnosis than those who underwent CT alone (53.0%).

Conclusion

The imaging findings of BCs in the chest are generally consistent. Misdiagnosis occurs frequently when CT attenuation values exceed 20 Hu. Diagnostic accuracy of BCs tends to improve with preoperative MR examination.