Intra-abdominal cystic lymphangiomas in children: A case series

Karkera, Parag; Sandlas, Gursev; Ranjan, Ritesh; Kesan, Krushnakumar; Gupta, Abhaya; Gupta, Rahul; Kothari, Paras

doi:10.4103/2278-9596.110037

Cited by 7 publications

(8 citation statements)

References 7 publications

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“…They are commonly located in the head, neck, and axilla and are rarely intra-abdominal. It is believed that lymphangiomas arise due to failure of connection between primitive lymphatic sacs and the surrounding lymphatic channels due to abnormalities in embryonic development [ 10 ]. This results in dilated lymphatic sacs and subsequent lymphangioma formation.…”

Section: Discussionmentioning

confidence: 99%

“…This results in dilated lymphatic sacs and subsequent lymphangioma formation. Other possible hypotheses propose acquired factors such as trauma, fibrosis, and inflammatory etiologies [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recurrence rate accounts for 10% of cases due to difficulty in resecting the entire cyst wall and is especially so for retroperitoneal cysts due to close relationship to vital retroperitoneal structures which make resection very hazardous or even impossible [ 11 ]. Postoperative complications in cases of ACL include peritonitis, haemorrhage, abscess, and torsion, which is a rare postoperative complication [ 10 ]. Wound infection, haemorrhage, hypertrophied scar, and lymphatic discharge from the wound are postoperative complications of axillary lymphangioma excision [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

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Cases of Atypical Lymphangiomas in Children

Minocha

Roop

Persad

2014

Case Reports in Pediatrics

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Background. Lymphatic malformations or lymphangiomas are rare benign hamartomas that result from maldevelopment of primitive lymphatic sacs. They are most frequently found in the neck and axilla, while intra-abdominal and mediastinal lymphangiomas are uncommon. These are primarily tumours of infancy and childhood and are successfully treated with surgical excision. Summary of Cases. Five cases of lymphangioma comprising three intra-abdominal lymphangiomas and two unilateral axillary lymphangiomas presenting at one institution in Trinidad W.I. between 2005 and 2012 were examined. The presentations, location, workup, treatment, and outcome of these patients were studied. Conclusion. This paper discusses a range of extracervical lymphangioma cases seen at San Fernando General Hospital, Trinidad W.I. We report three intra-abdominal cases and the most common clinical presentations were abdominal pain and distension. Also two axillary cases were reported, which presented as painless axillary masses. The major concerns for excision of axillary lymphangioma by parents and surgeons were cosmesis and feasibility of complete resection without disruption of developing breast tissue and axillary vessels. We believe that ultrasound scan is very good at detection of the lesion, while CT is better at determining tumour content and planning for the operation. It is our opinion that complete surgical excision can be achieved.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cases of Atypical Lymphangiomas in Children

Minocha

Roop

Persad

2014

Case Reports in Pediatrics

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“…While intra-parenchymal involvement of solid organs with lymphangiomas have been described in literature, these are rare, with intra-abdominal lymphangiomas still predominantly centred on the mesentery/omentum or retroperitoneal space. 4 This case also highlights the very high possibility of an underlying genetic condition, given the sheer multiplicity of the cysts as well as the early age of presentation of this patient. Involvement of the pancreas in VHL patients has been reported in 25-70% of cases, and in most cases, these are usually of true pancreatic cysts.…”

Section: Discussionmentioning

confidence: 71%

Curious case of paediatric multiple pancreatic cysts

Muljadi

Teo

Tiong

et al. 2020

J Paediatrics Child Health

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DescriptionIsolated pancreatic cysts are extremely rare in children and often pose certain diagnostic challenges. This is especially true when they are large in size and cause mass effect on adjacent organs. In these cases, the main differential diagnostic considerations apart from primary pancreatic cystic lesions would include duplication cysts or retroperitoneal cystic lymphangiomas, with the latter differentials more common in the paediatric population. We present a case of a child with multiple pancreatic cysts, with radiological appearance mimicking cystic lymphangioma in the upper abdomen. Case ReportTwenty-month-old child presented with intermittent abdominal discomfort and a palpable mass on the left side of the abdomen.The child is otherwise well. She was born from nonconsanguineous parents with no known family history of genetic disorders. Ultrasound demonstrates multilocular cystic structure at the left flank with internal septa (Fig. 1). There was no solid component or internal vascularity seen. It abuts the left kidney, but does not seem to arise from it. The sonographic appearance favours a non-aggressive lesion, with cystic lymphangioma being the main consideration.Subsequently computed tomography abdomen followed by magnetic resonance imaging abdomen (Fig. 2) were performed, which confirm the presence of a large, multiseptated cystic lesion involving the pancreatic body and tail. There is mass effect with indentation and displacement of the gastric body and the left kidney. The pancreatic body/tail appears to be replaced by the lesion. Although atypical, the main consideration at reporting was that of a cystic lymphangioma.Decision was made to proceed to diagnostic aspiration and injection of sodium taurocholate 3% into the cyst. Clear fluid was aspiration and contrast was subsequently injected into the locules, showing some communications with each other. The aspirated fluid shows extremely high amylase (45 341 U/L) and lipase level (335 200 U/L), suggestive of cysts of pancreatic origin with possible communication with the pancreatic duct.Patient then underwent spleen preserving distal pancreatectomy. The cut sections show absence of normal pancreatic parenchyma which is replaced by multiple thin walled cysts ranging from 0.3 to 5.5 cm containing haemoserous fluid (Fig. 3).Microscopically, these cysts are lined by a single layer of bland cuboidal to flattened ductal-type epithelium with surrounding fibrosis. There is intervening scant atrophic pancreatic parenchyma. No atypia, necrosis or mitotic activity seen. No evidence of malignancy.Patient recovered well post-operatively and was discharged a few days afterwards. Concerns were raised whether patient has underlying syndromes, in particular von Hippel-Lindau (VHL). Patient's family, however, declined genetic testing.

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“…Lymphangioma is a benign congenital malformation characterized by proliferation of lymphatic vessels, resulting from the failure of communication between the primitive lymphatic sacs and the venous system, leading to the formation of a cystic structure [ 1 ]. Rarely, it is an acquired malformation, due to inflammation, injury, or fibrosis [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Cystic Lymphangioma of the Chest Wall in a 5-Year-Old Male Patient: A Rare and Atypical Localization—A Case Report and Comprehensive Review of the Literature

Patoulias

Kaselas

et al. 2017

Case Reports in Pediatrics

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Lymphangioma is a benign congenital malformation. The extremely rare and atypical localization of a lymphangioma in the chest wall was the real motive for the present case study. A 5-year-old boy was admitted to the Emergency Department of the 1st Department of Pediatric Surgery, Aristotle University of Thessaloniki, due to the presence of a mildly painful swelling in the left lateral chest wall, which was first noticed three months ago, after a blunt injury during sport. Physical examination revealed the presence of a palpable, spherical, painful, nut-sized subcutaneous lesion in the left lateral chest wall, respectively, with the anterior axillary line, at the height of the 6th to 7th intercostal space. Presence of ecchymosis on the overlying skin was also noticed. During palpation, we did not notice fluctuation, while transillumination was not feasible. Performance of ultrasonography, including Doppler color flow imaging, followed, depicting a subcutaneous cystic lesion, 2.1⁎3.2 cm in dimensions, without extension to the thoracic cavity. Scheduled surgical excision of the lesion was decided. Histopathological examination documented the diagnosis of cystic lymphangioma. Patient is still followed up on a 6-month basis. He remains asymptomatic, after 2 years, without indication of relapse.

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Intra-abdominal cystic lymphangiomas in children: A case series

Cited by 7 publications

References 7 publications

Cases of Atypical Lymphangiomas in Children

Cases of Atypical Lymphangiomas in Children

Curious case of paediatric multiple pancreatic cysts

Cystic Lymphangioma of the Chest Wall in a 5-Year-Old Male Patient: A Rare and Atypical Localization—A Case Report and Comprehensive Review of the Literature

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