Laparoscopic segmental colectomy for colonic lymphangiomas: A definitive, minimally invasive surgical option

Abstract

Colonic lymphangioma is an unusual benign malformation. We herein describe two cases. A 36-year-old woman was admitted with one year of intermittent abdominal pain; colonoscopy, abdominopelvic computed tomography and endoscopic ultrasonography (EUS) revealed enlarged cystic masses at the ascending colon. In another 40-year-old man, colonoscopy and EUS revealed an asymptomatic lobulated cystic mass with four small sessile polyps at the sigmoid colon. Both patients underwent laparoscopic segmental colectomy. Both masses were histologically confirmed as cystic lymphangiomas, and the patients were discharged without complications. The management of colonic lymphangioma depends on the individual situation; close surveillance or endoscopic therapy may be appropriate for asymptomatic lesions smaller than 2.5 cm in diameter. Surgical intervention can be considered for larger lesions or in patients who develop complication risks. Laparoscopic segmental colon resection may be recommended to excise relatively large submucosal lesions because it is a definitive, minimally invasive intervention with a fast postoperative recovery.

Subserous lymphangioma of the sigmoid colon: an uncommon cause of acute abdomen in pediatric patients

“…12 - 16 In the colon, lymphangioma are usually submucosal and may present as polypoid lesions that may bleed and cause hemorrhage or anemia. 17 Insidious, but progressive, abdominal distention resembling ascites occurs in 18-20% of the cases. 18 Malnourishment is uncommon, but undernutrition may be present in cases where intestinal lymphangiectasis is present, leading to refractory diarrhea and malabsorption syndrome.…”

“…Their external surface is smooth, thin walled, yellowish, grayish, or yellow-pink in color, appearing as multiple cysts or a spongy mass containing watery or milky fluid. 17 The cut surface may show interconnecting cysts, which may contain a clear, chylous, serous, or gelatinous liquid where foamy macrophages, leukocytes, or hemorrhage may be found. Microscopically, the cysts are lined by a flat epithelial endothelium, circumscribed by connective tissue, small lymphatic spaces, smooth muscular fibers, and lymphoid follicles or aggregates, and foam cells.…”

“… 6 , 7 , 23 Malignant transformation does not occur, but in the case of colonic lymphangioma, colon cancer or adenoma may be concurrently diagnosed. 17 …”

Lymphangiomatosis of the sigmoid colon - a rare cause of lower gastrointestinal bleeding: A case report and review of the literature

“…Colonic lymphangioma used to be considered an extremely rare disease, but recently, along with the increasing prevalence of endoscopy and endoscopic ultrasound (EUS), it has become more commonly encountered and has been reported more frequently (5,6). There are several reports on the use of EUS for the diagnosis of colonic lymphangioma (4,6). The present study reports a case of colonic lymphangiomatosis manifested as recurrent bowel bleeding, which was diagnosed by EUS and treated with laparoscopic segmental sigmoid colon resection.…”

“…The majority of lymphangiomas usually occur in the head, neck regions and axillary areas, but rarely in the colon (2)(3)(4). Colonic lymphangioma used to be considered an extremely rare disease, but recently, along with the increasing prevalence of endoscopy and endoscopic ultrasound (EUS), it has become more commonly encountered and has been reported more frequently (5,6).…”