A case of retroperitoneal lymphangioma successfully treated by pancreatoduodenectomy

A rare case of retroperitoneal lymphangioma in 44-year-old male complaining of high fever and right hypochondralgia is reported. Retroperitoneal malignant tumor was suspected preoperatively, and pancreatoduodenectomy was performed because the tumor infiltrated to duodenum and head of the pancreas. Histopathological examination revealed that the tumor was lymphangioma infiltrating to the duodenum. There are two types of lymphangioma, solitary lymphatic cyst and true proliferating lymphangioma and in this case, the tumor is diagnosed as true proliferating lymphangioma which is cavernous and infiltrating.     

Cystic lymphangioma of adrenal gland

An 18 year old female presented with vaginal bleeding at 2 months of gestation. Ultrasonography revealed a large retroperitoneal cyst. Histopathological examination of the excised cyst showed features suggestive of a cystic adrenal lymphangioma. This case is reported because of its rarity and detection during pregnancy.     

A case of retroperitoneal chylous cyst developed after cholecystectomy and choledochotomy

A 43-year-old woman complaining of upper abdominal pain was referred to our clinic. Well movable mass was detected in the right hypochondria region by palpation. Three years before, she underwent cholecystectomy and choledochotomy for cholelithiasis. After that she had been aware of painless mass in the right hypochondria region, but because of no symptom she regarded it as operative scar and had no treatment. Abdominal CT, ultrasonography, upper GI series and barium enema revealed a retroperitoneal cyst compressing the 3rd portion of the duodenum upward and the vena cava backward. Laparotomy showed an unilocular chylous cyst, 5 cm in diameter in the retroperitoneal cavity. Histologically, the cyst was cystic lymphangioma. Etiologically, the previous operation of cholecystocholedocholithiasis was supposed to be a trigger of the development of the chylous cyst.     

原发性腹膜后巨大淋巴管瘤1例报告并文献复习

目的：提高原发性腹膜后淋巴管瘤的诊治水平。方法：报道1例原发性腹膜后淋巴管瘤患者的诊治过程,术前诊断腹膜后囊肿,行单孔腹腔镜双侧腹膜后囊肿切除术。结果：术后病理（腹膜后囊肿）检材由扩张的淋巴管组成,囊壁由内皮细胞、平滑肌及纤维组织组成,符合腹膜后淋巴管瘤。术后随访6个月未见复发。结论：原发性腹膜后淋巴瘤是一种良性病变,临床罕见,确诊需结合术后病理和影像学表现,手术切除是最佳治疗方式。     

A case of retroperitoneal cystic lymphangioma]

A case of retroperitoneal cystic lymphangioma in a 62-yr-old woman presented as symptom-free abdominal swelling. The intraoperative diagnosis was confirmed histologically. Radical management consisted of stripping of the cyst from its adjacent structures. The postoperative course was uneventful.     

A case of retroperitoneal cavernous lymphangioma with the content of chylous fluid

We report a case of retroperitoneal lymphangioma in a 26-year-old man whose chief complaint was lumbar discomfort. Ultrasonography revealed pararenal cyst on his left side. At the operation, we discovered a cystic tumor between peritoneum and Gerota's fascia. Pathological study indicated cavernous lymphangioma containing chylous fluid. There has been no recurrence for a year after the operation.     

Cystic lymphangioma of retroperitoneum and groin

We report a case of cystic lymphangioma of the retroperitoneum and groin. A 38-year-old male was referred to our hospital due to a right inguinal mass without tenderness. CT, MRI revealed retroperitoneal mass and inguinal mass. Biopsy of the inguinal mass was performed. The lesion was multicystic, and adherent to the surrounding tissue. Pathological examination revealed lymphangioma.     

Adrenal cyst: report of a case

A 32-year-old woman was admitted because of a large abdominal mass in the right upper quadrant. Laboratory findings including hormonal studies were within normal ranges. CT scan and various X-ray examinations revealed a large adrenal cyst on the right side. On May 2, 1984, an adrenal cyst was removed through the right flank incision. Histological study showed that the wall of the cyst consisted of fibrous tissue with endothelial linings and dilated lymphatic vessels. Thus it was classified as a lymphangiomatous adrenal cyst.     

A case of retroperitoneal serous cyst with ossification

A 36-year-old woman came to our hospital complaining of right flank pain. Computed tomographic (CT) scanning showed a cystic mass, 6 x 9 cm in size, including homogeneous low-density fluid contents, in the right retroperitoneal space. The cyst wall showed partly high-density epithelium, but there was no contrast enhancement. A 7.5 x 12 cm retroperitoneal cyst was easily removed with yellow serous fluid in it. Cytological examination showed no malignant cells in this fluid. The origin of the cyst was unknown. The histopathological diagnosis was retroperitoneal serous cyst with focal ossification in the lining epithelium. Here we report this rare case of retroperitoneal serous cyst and briefly discuss 57 cases reported in Japan.     

腹膜后淋巴管瘤的诊断与治疗

腹膜后囊性淋巴管瘤临床少见，这是一种淋巴管畸形或发育障碍所致的疾病。作者近２０年间收治６例。首发症状为腹部肿块及消化道功能障碍。术前确诊仅１例，其余误诊为胰腺囊肿，畸胎瘤及卵巢囊肿。６例均行手术治疗，单纯囊肿切除３例，囊肿大部分切除２例，囊肿并胰尾切除１例。手术均获成功。术后随访１～１９年，均未复发。作者认为，Ｂ超、ＣＴ对此病的诊断有重要意义，手术切除是目前治疗本病的理想方法。     

Retroperitoneal lymphangioma

Lymphangiomas are rare cystic tumours that may present as cystic masses in the retroperitoneum. Retroperitoneal lymphangiomas account for approximately 1% of all lymphangiomas. Confusion with other cystic tumours of the retroperitoneum including those arising from the liver, kidney and pancreas is common. A case of a retroperitoneal cystic lymphangioma occurring in a 41-year-old woman raising interesting diagnostic and management issues is reported. The patient presented with vague abdominal pain and persistent nausea. Radiological imaging demonstrated a large multiloculated thin-walled cyst involving the upper retroperitoneum. Surgical resection was complete, revealing a benign cavernous lymphangioma. The patient made a complete recovery and was disease-free 30 months postoperatively.     

A case of primary retroperitoneal mucinous cystadenocarcinoma

A 41-year-old Japanese woman was admitted to our hospital for right abdominal mass. Various examinations revealed a retroperitoneal lymphangioma. Tumor resection was performed and pathological diagnosis was a mucinous cystadenocarcinoma. It seems that screening with the tumor markers will be helpful for the diagnosis, because it is very difficult to diagnose a retroperitoneal mucinous cystadenocarcinoma before the operation.     

Urethral obstruction owing to retroperitoneal cystic lymphangioma

We report a case of cystic lymphangioma arising from retroperitoneal tissues of the pelvis, which caused urethral obstruction and eventual urinary retention. Sonography and computerized tomography demonstrated a retroperitoneal cystic mass in the pelvis. A preoperative diagnosis of retroperitoneal cystic lymphangioma was suggested by typical computerized and sonographic features.     

A case report of mediastinal cystic lymphangioma

Mediastinal lymphangioma is very rare in the literature. A resected case of mediastinal cystic lymphangioma was reported. A 41-year-old man admitted to our hospital complaining of sore throat. A chest X-ray examination showed a large mediastinal mass on the right. At the right thoracotomy, a large cystic mass filled the anterior mediastinum and extended from the thoracic inlet to the posterior costophrenic angle. The cyst contained about 600 ml yellowish brown fluid and was adherent to the surrounding tissue, especially to the aorta and the left main bronchus. The resected tumor was 20 x 12 x 10 cm in size and 620 g in weight. Histological diagnosis was cystic lymphangioma. The patient is alive and well 26 months later, and there is no sign of recurrence of the tumor.     

Laparoscopic excision of a retroperitoneal cystic lymphangioma in an elderly patient

A 68-year-old male patient was referred to our hospital due to protrusion and pain in the right iliac fossa. On physical examination a palpable oval tumor was found. Ultrasonography and computed tomography revealed a cystic mass in right iliac fossa. The tumor was successfully excised laparoscopically and histologically diagnosed as cystic lymphangioma. Retroperitoneal cystic lymphangiomas are rare lesions, most often seen in pediatric patients. Surgical excision is the treatment of choice because of its potential to grow and develop complications, especially due to mass effect. The laparoscopic approach is a safe and effective alternative for treatment of retroperitoneal cystic lymphangioma in the elderly.     

Surgical therapy of abdominal cystic lymphangioma in adults and children

BACKGROUND: Cystic lymphangioma is a rare malformative benign tumor of the lymphatic vessels. In the abdomen it generally develops as a mesenteric and/or retroperitoneal cyst, but any organ can be involved. The present retrospective study aims to define the symptoms, complications and differences noted between adults and children suffering from abdominal cystic lymphangioma; it is based on patients who underwent surgery for this condition at the Geneva University Hospital. PATIENTS AND METHODS: Since 1995, 16 patients (9 adults and 7 children) were surgically treated for abdominal cystic lymphangioma. Their medical files were reviewed retrospectively. The follow-up was based either on the last physical examination or on a telephone interview with the patients. RESULTS: The mean follow-up was 45 months. The most common presenting symptom was abdominal pain (38%). Ultrasonography was the most efficacious diagnostic modality. The lesions were mostly micropolycystic (44%), and found in retroperitoneal locations (50%). The surgical excision was complete in 14 patients and partial in 2 patients. These last 2 were the only ones who developed complications after the surgery, including one recurrence. CONCLUSIONS: A total surgical excision, if feasible without a major sacrifice of adjacent organs, seems to be the best therapeutic option to minimize the risk of recurrence of symptomatic abdominal cystic lymphangiomas. In our clinical experience, the presentation and evolution of the abdominal cystic lymphangioma seemed to be similar in adults and children.     

Renal lymphangioma: report of a case

Renal lymphangioma is a very rare benign tumor caused by failure in the development of the lymphatic communication system. Since December 1997, a 55-year-old man with chronic B-type virus hepatitis has been followed at our hospital. Neither kidney showed any sign of cysts at that time. In November 2000, ultrasound sonography showed a right renal simple cyst measuring 1.0 cm in diameter. Thereafter, the initial cyst increased to 5.5 cm and numerous right renal cysts, appearing similar to multilocular renal cysts, were detected in December 2004. Computed tomography demonstrated a right renal multilocular cystic tumor, 5.5 cm in diameter, which was enhanced by contrast medium. Radical nephrectomy was performed, and the pathological diagnosis was renal lymphangioma based on positive staining with D2-40 antibody, which is reactive to endothelial cells of the lymphatics.     

Abdominal lymphangioma in children: Report of three cases

Most cases of abdominal lymphangioma are asymptomatic. However, patients may occasionally present with acute abdomen because of an intestinal obstruction or peritonitis caused by infected cysts, hemorrhaging, and/or torsion. These conditions may differ based on the location of the lymphangioma and do not always require emergency surgery. This report presents two cases of abdominal lymphangioma derived from the omentum, which required emergency surgery because of severe abdominal distension and peritonitis caused by torsion, respectively. In contrast, another case of retroperitoneal lymphangioma presented with acute abdomen and underwent elective surgery after conservative therapy for peritonitis. Elective surgery is acceptable if the symptoms are controllable under conservative therapy. However, it is important not to overlook the possible lethal complications such as intestinal and/or urological obstruction, aggressive peritonitis, and torsion of the cyst, which require emergency surgery.     

Adrenal cystic lymphangioma. A case report]

Adrenal cysts are uncommon. A case of left adrenal cystic lymphangioma in 16 year old boy is reported. The adrenal cyst was a chance finding during radiological investigation for abdominal pain. Ultrasound and CT scan showed the cyst and suggested the correct diagnosis of cystic lymphangioma of the left adrenal gland. The patient underwent surgery and a left adrenalectomy was performed. Histology confirmed the previous diagnosis of cystic lymphangioma.     

腹膜后巨大海绵状淋巴管瘤的手术治疗一例并文献复习

目的探讨对腹膜后巨大海绵状淋巴管瘤手术治疗方法的认识,提高治疗水平。方法回顾性分析1例成人腹膜后巨大海绵状淋巴管瘤的手术治疗过程,并结合文献复习讨论。结果腹膜后巨大海绵状淋巴管瘤完整切除,手术顺利,术后恢复好,未发生任何手术并发症。结论手术切除腹膜后巨大海绵状淋巴管瘤,需熟悉局部解剖关系,妥善保护周围组织,结扎离断与肿物相连的筋膜、淋巴管和血管组织,完整切除肿瘤,术后充分引流。