Giant Cystic Lymphangioma of the Small Bowel Mesentery: Report of a Case

Abstract

We herein describe the case of a 48-year-old man who presented to our hospital with abdominal distension and pain. Preoperative studies including abdominal ultrasonography and computed tomography failed to determine the cause of the pain. At laparotomy, a giant cystic tumor of the small bowel mesentery was found. Histologically, the tumor was diagnosed as a cystic lymphangioma. Although mesenteric lymphangiomas are rare, especially in adults, they should be considered as a possible cause of acute abdomen.

Mesenteric Lymphangioma with Small Intestinal Volvulus in an Adult

“…The cystic content is usually sonolucent, but may be echogenic when intracystic bleeding or calcifications are present. An abdominal CT scan allows evaluation of the water density of the tumor, its relationship with neighboring organs, and definitions the mass effect on the intestines [8].…”

“…Complete resection is the first-choice treatment for suspicion of a mesenteric lymphangioma. Some researchers have proposed intracystic injections of sclerosing agents for non-resectable lesions, when radical resection might be technically impossible [8]. Rarely, mesenteric lymphangioma can cause fatal complications, such as volvulus or involvement of the main branch of the mesenteric arteries requiring emergency surgery, particularly in adults [6].…”

Mesenteric cystic lymphangioma presenting as acute peritonitis

“…The peritoneal cavity is a location of such lesions in less than 5% of cases. Although lymphangiomas can occur in the retroperitoneal space or in the major omentum, the small bowel mesentery and mesocolon are the most common abdominal locations of the disease due to the abundant lymphatic network [3]. These tumours are more prevalent in chil- .…”

“…They are located within soft tissues of the neck in about 90% of cases and they can occasionally descend into the superior mediastinum. The bowel mesentery, retroperitoneal space and major omentum are less frequent involvements of that lesion [3]. Clinical presentation of mesenteric lymphangioma depends on diameter and location of the lesion as well.…”

Cystic lymphangioma of small bowel mesentery: a rare case report

“…1,5,8,9 Treatment of choice is enucleation; resection of the adjacent bowel may occasionally be necessary. Morbidity and mortality is very low because of modern surgical techniques and follow-up procedures.…”