Prenatal Ultrasound Evaluation and Outcome of Pregnancy with Fetal Cystic Hygromas and Lymphangiomas

Abstract

Cystic hygroma is a type of lymphangioma, which is a vascular anomaly associated with lymphatic malformations and formed by fluid accumulation mainly located at the cervi-cofacial and axillary regions. Cystic hygroma is mostly located in the neck (75%), followed by axilla (20%), retroperitoneum and intra-abdominal organs (2%), limbs and bones (2%), and mediastinum (1%). It is often associated with chromosome aneuploidies, hydrops fetalis, and even intrauterine fetal demise. The prognostic factors of the fetal cystic hygroma or lymphan-gioma are chromosome abnormalities, hydrops fetalis, septations, or thickness of the cystic hygroma and are associated with other major malformations. Prenatal managements including ultrasound serial follow-up, magnetic resonance imaging, or even intrauterine injection of sclerosing agents are suggested. For fetus with the risk of airway obstruction at delivery, ex utero intrapartum treatment is also indicated. Detailed prenatal counseling is necessary for better neonatal outcome.

Prenatal ultrasound and magnetic resonance evaluation and fetal outcome in high‐risk fetal tumors: A retrospective single‐center cohort study over 20 years

“…Prognosis of fetal lymphatic malformation has been related to lesion size, cystic and solid components, and presence of septations. 20,26,[28][29][30][31] In the 13 cases presented, we found no association whatsoever between location, lesion size or classification 20…”

Fetal axillary lymphangioma

“…7 In the ultrasound lesion may be unilocular, but more often the structure has been multicystic, hypoechogenic, with thin septa and may contain solid components. 4,7 The absence of blood flow on color Doppler mapping is characteristic of lymphangiomas. 2 The detection of blood flow signals within the mass by color Doppler raised the possibility of an associated hemangiomatous component or tumor bleeding.…”

“…3 Other locations include the axilla (20%), the retroperitoneum and the intra-abdominal organs (2%), the limbs and the bones (2%), and the mediastinum (1%). 4 They occur due to the lack of development of communication between the lymphatic and the venous systems during the sixth week of intrauterine life. 2 Unlike cystic hygroma, axillary lymphangioma appears not to be associated with fetal aneuploidy and is diagnosed later in pregnancy.…”

Children with lymphatic malformations and their treatment using video-endoscopic equipment

“…По данным различных авторов, распространенность лимфангиом составляет от 1 на 2000-4000 рождений [8] до 1: 6000 [9][10][11]. Есть мнение, что распространенность лимфангиом у новорожденных и детей раннего возраста составляет 1 на 60 тыс.…”