Abstract. Hemolymphangioma is a malformation of the lymphatic and blood vessels. To the best of our knowledge, only a limited number of hemolymphangioma cases have been reported in the literature thus far, with no cases developed in the waist region. The present study reported the case of a 17-year-old male patient with hemolymphangioma growing on the waist, presented with back pain for four months. Upon physical examination, the lesion was identified to be oval in shape, soft and compressible, with mild tenderness. No abnormalities were detected in the results of laboratory examinations. However, a magnetic resonance imaging (MRI) scan revealed a tumor with low signal intensity on T1-weighted imaging (WI) and high signal intensity on T2-WI. The mass was successfully removed during surgery. During the seven-month follow-up period, the patient was asymptomatic with no evidence of recurrence. The present study discussed the imaging findings and pathological features of this uncommon case and reviewed the relevant literature.
IntroductionLymphangioma, also known as angioma lymphaticum, is a congenital malformation of the vascular system, comprising newly-formed lymph spaces and channels (1). Landing and Farber (2) classified this benign malformation in four categories, including capillary, cavernous and cystic (hygroma) lymphangioma, and hemolymphangioma, which is a combination of hemangioma and lymphangioma.Hemolymphangioma is a congenital malformation that may be asymptomatic for a long period of time (3). This lesion is typically considered to be a benign and noninvasive disorder, characterized by the presence of dilated lymphatic spaces, extravasation of red blood cells, hemosiderin deposition and fibrosis (4). Hemolymphangioma formation may be due to venolymphatic communication obstruction between the dysembrioplastic vascular tissue and systemic circulation (5).The incidence of hemolymphangioma is 1.2-2.8 per 1,000 newborn infants (6). Hemolymphangioma has been previously detected at the pancreas (5,7-12), spleen (13-16), stomach (1,17), rectum (18), mediastinum (19-21), chest wall (22-25), small intestine (26), extremities (3,27,28), cervix (29,30), pericardium (31), oral region (32), esophagus (33), axilla (34), retroperitoneal space (35,36), adrenal gland (37), abdomen (38), duodenum (4) and hepatica (39), as well as on the tongue (40,41) and orbit (42,43). However, to the best of our knowledge, no studies have reported this type of tumor in the waist region, as determined by a review of the medical literature until June 2014 using the PubMed database (http://www.ncbi.nlm.nih.gov/pubmed; accessed on 9th June 2014). Complete excision is considered the optimal treatment for hemolymphangioma, which exhibits a low recurrence rate. Non-surgical treatments are also used, including aspiration and drainage, cryotherapy, injection of sclerotic agents, laser therapy and radiotherapy, however, to date, the outcomes of such treatments have been unsatisfactory (3,22). In cases of tumor recurrence, conservative treatmen...