Large mesenteric lymphangioma in an adult patient: an unusual presentation of a rare disease

Abstract

Lymphangiomas are most commonly described as a small painless mass in the neck or a vesicular rash in an infant patient. Ninety per cent of cases are diagnosed before the age of 2. Treatment usually involves surgical resection. Intra-abdominal lymphangiomas and mesenteric lymphangiomas, as described in our case report, represent a rare pathology. The exact prevalence of this condition is unclear but it has been suggested in the literature that there have been as few as 820 cases since the 16th century. The clinical presentation is usually subacute and diagnosis made incidentally during a workup of chronic gastrointestinal symptoms. Acute abdominal symptoms, as in our case presentation, are unusual but may be explained by the mass effect of a large intra-abdominal lesion. Cross-sectional imaging is key in preoperative workup and operative planning. Complete surgical resection is recommended and curative in the majority of cases with a low risk of local recurrence.

Mesenteric lymphatic malformation mimicking an adnexal source in a teenager

“…Surgical intervention is almost always curative if a complete resection is achieved. 1 In the patient presented, her lesion is essentially asymptomatic, and she is unlikely to achieve a complete resection considering the size and complexity of the mass. She additionally is not an optimal candidate for sclerotherapy due to the proximity of her complex lesion to surrounding great vessels.…”

“…Risks of leaving this lymphatic malformation in place include the cyst becoming secondarily infected, a potential to invade other structures, and life threatening complications such as a volvulus or acute bowel obstruction. 1,3,9,10 However, in her current asymptomatic state, watchful waiting is deemed the most judicious approach.…”

“…Lymphatic malformations are rare congenital abnormalities that often present in the first few years of life, with 90% presenting in the first two years. 1 The majority of cases (95%) are located in the neck and axilla, with abdominal locations making up a mere few percent of the condition. 2 The exact prevalence of the condition is unclear, but it has been suggested in some literature that there may be as few as 820 cases of abdominal mesenteric lymphatic malformations since the 16th century.…”

“…2 The exact prevalence of the condition is unclear, but it has been suggested in some literature that there may be as few as 820 cases of abdominal mesenteric lymphatic malformations since the 16th century. 1 Other literature indicates there have been less than 200 reports of mesenteric lymphatic malformations published in the English language literature. 3 The clinical picture varies widely, as some patients present with subacute diffuse abdominal discomfort, while others present with acute symptoms mimicking appendicitis.…”

Cavernous Lymphangioma of the Digits: A Rare Cause of Macrodactyly

“…Complete surgical resection is still the recommended treatment for lymphangiomas (Wall et al 2018). But local recurrences are common as adequate excision of lymphangiomas can be difficult and, at times unfeasible (Blair et al 1983).…”