Phlebectasia of persistent left superior Vena Cava accompanying a giant cervico-mediastinal lymphangioma: multidedector CT findings

Background: Lymphatic malformations (LM) are rare, often presenting as congenital abnormal growth of lymphatic vessels diagnosed most commonly in the pediatric population. Venous anomalies are rarely seen with cystic hygromas. In this paper, we present the MDCT and MDCT angiography findings in an unusual case of phlebectasia of persistent left superior vena cava (PLSVC) accompanied that of lymphatic malformation. Case Report: A 6-week-old full-term male was brought to the emergency department with a 2-week history of progressive left neck swelling and tenderness. On examination, the left lateral neck was notable for an 8 x 6 cm soft mass that transiently expanded with crying. Multimodality imaging evaluation of the neck and thorax showed multiloculated cystic lesions on the left side of the neck spreading through the soft tissues. MDCT examination reveals location and extent of the cystic hygroma and a PLSVC connected with dilated coronary sinus. Conclusions: Due to different MDCT post-processing techniques, even complex vascular malformations are visualized in an understandable way even for preoperative planning. Knowledge of venous anomalies may be helpful to the surgeon planning resection of a cystic hygroma.