Lymphangioma of the gallbladder in childhood: a case report and review of the literature

Lymphangiomas are malformations of the lymphatic system, which is a common disease in children, usually superficial in body, but seldom seen in visceral organs. We present the case of a child with lymphangioma of the gallbladder. Also we reviewed the literatures. A 2-year-6-month-old boy complained of progressing difficulty in walking for 6 months. Cerebral MRI showed abnormal signals in the white matter suggesting leukodystrophy. Ultrasound of abdomen showed a mixed-echoic mass in the site of gallbladder. CT scan showed an enlarged gallbladder with increased density. Bloodcounting, liver function, and alpha fetal protein were within normal range. Exploratory laparotomy was done in order to rule out malignancy. The liver was found normal at surgery, and the gallbladder looked enlarged and deformed. The gallbladder wall was thick and edematous, and adherent with liver. The gallbladder was excised. Pathological examination gave the diagnosis as lymphangioma of the gallbladder wall. The postoperative recovery was uneventful. There was no evidence of recurrence. Searching in literatures, three cases of lymphangioma of gallbladder in adults were found. According to the pathology of lymphangioma and the anatomy of gallbladder, the outcome of this disease should be benign and may be symptomless throughout the life. No death was reported due to lymphangioma of gall bladder, nor severe complications endangering life at any age. The only indication for surgery in the reported cases was to rule out the risk of being malignancy. If MRI or other means can make a definite preoperative diagnosis of lymphangioma, being a stable lesion, surgery would be unnecessary unless there is a progressive organic obstruction causing repeated infection or persistent abdominal pain. Chin Med J 2011;124(24):4359-4360