Mesenteric cystic lymphangioma: Case report

Cystic lymphangioma is an uncommon, slowly growing tumor derived from of the lymphatic vessels, which is rarely found as intra-abdominal masses usually located in the small-bowel mesentery, followed by the omentum, mesocolon and retroperitoneum. A 66 month-old girl presented with diffuse abdominal distention and severe colicky pain after a 2-month history of abdominal discomfort. Physical examination revealed severe abdominal distention and a palpable abdominopelvic mass localized on the right side of the abdomen. An abdominal CT scan revealed a cystic mass, about 13 x 7 cm x 6.9 cm in size, at the right upper and lower quadrant, which compressed the adjacent bowel loops. The child underwent an emergency laparotomy under general anesthesia. There were two cystic mass (6 x 8 cm and 6 x 7 cm) lesions with cystic and solid areas in the jejunal mesentery adjacent to the bowel wall, about 150 cm from the ileocecal valve. The mesenteric mass was excised with about 10 cm jejunal segment, and bowel continuity was achieved by end-to-end hand-sewn anastomosis. Pathological examination confirmed a diagnosis of mesenteric cystic lymphangioma containing chylous milky fluid. The patient remained well at 3 months from the surgery. Abdominal cystic lymphangiomas is an intra-abdominal cystic mass usually affecting infants and young children, which may be detected incidentally or present with acute life-threatening abdominal obstruction. A total surgical excision seems to be the best therapeutic option in order to minimize the risk of recurrence of symptomatic abdominal cystic lymphangiomas.