Progressive fetal axillary cystic lymphangioma with coexistent naevus flammeus

Abstract

We report the rare occurrence of a progressive fetal axillary cystic lymphangioma coexistent with an overlying naevus flammeus. The fetus at 22 weeks' gestation was found to have a 37 x 35 mm left axillary multiloculated mass without colour-flow imaging. Amniocentesis showed a normal 46,XX karyotype. Multiple fine-needle aspirations of the mass in the second and third trimesters obtained blood-stained chocolate-coloured fluid containing numerous erythrocytes and lymphocytes but proved ineffective in lessening the progressive growth of the mass. The mother underwent caesarean delivery and a healthy neonate was born with a 141 x 81 mm left axillary cystic lymphangioma and a 50 x 35 mm coexistent naevus flammeus. The neonate was well after simple excision of the lesions. Although cystic lymphangiomas arising in the axilla enlarge progressively during fetal life, our case suggests a good prognosis and except for genetic evaluation, no prenatal intervention is required.

Natural Course of Fetal Axillary Lymphangioma Based on Prenatal Ultrasound Studies

“…We searched PubMed, Scopus, and the Web of Science for all consecutive cases of fetal axillary cystic hygroma or lymphangioma as well as hemangiolymphangioma. Up to May 2017, 25 cases of axillary lymphangioma were published, as presented in Table . The review included only cystic hygromas and lymphangiomas mainly located at the axilla, but they might extend to the chest wall, the neck, or even the thorax.…”

“…Up to May 2017, 25 cases of axillary lymphangioma were published, as presented in Table 1. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The review included only cystic hygromas and lymphangiomas mainly located at the axilla, but they might extend to the chest wall, the neck, or even the thorax. Together with 5 our own cases, a total of 30 cases were analyzed and summarized as follows: be taken into account for decisions on the route of delivery.…”

“…(7) Unlike cystic hygroma colli, which is much more common, axillary lymphangioma appears not to be associated hydrops fetalis, although minimal ascites or pleural effusion can possibly be encountered in some cases. (8) The best treatment is yet to be explored, but surgical excision is a main technique of choice, whereas a sclerosing agent may be an alternative. Conservative or expectant management is possible in less severe cases.…”

Mixed Capillary/Lymphatic Malformation with Coexisting Port-Wine Stain: Treatment Utilizing 3D MRI and CT-Guided Sclerotherapy

“…5 The located lymphangioma must be differentiated from acquired lymphangioma, which is due to lymphatic congestion after damage to the deeper lymphatic vessels. 11,12 Chen et al 11 reported a fetal axillary cystic lymphatic malformation coexisting with an overlying PWS. 11,12 Chen et al 11 reported a fetal axillary cystic lymphatic malformation coexisting with an overlying PWS.…”

“…10 To our knowledge, the classical lymphatic malformation with coexistent PWS has been reported only twice in literature. 11,12 Chen et al 11 reported a fetal axillary cystic lymphatic malformation coexisting with an overlying PWS. The neonate underwent surgical treatment of the lesion.…”