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.     

Laparoscopic excision of a retroperitoneal cystic lymphangioma: an insidious case

Cystic lymphangioma is a rare, benign malformation of the lymphatic system. In this paper, we describe a rare case of a retroperitoneal cystic lymphangioma in a 25-year-old woman.     

Total laparoscopic excision of retroperitoneal ganglioneuroma: A case report

IntroductionGanglioneuromas are rare benign tumors originating from neural crests and typically affect young adults. The most frequent locations are the posterior mediastinum, retroperitoneum and adrenal gland. In general, retroperitoneal ganglioneuromas are discovered incidentally or by mass effect. In the literature, the number of retroperitoneal masses reported is quite limited. We report a case of laparoscopic excision of a retroperitoneal ganglioneuroma.Presentation of caseThe patient was a 40-year-old woman who visited a nearby clinic with anorexia and vomiting. She was referred to our hospital after the detection of an abdominal mass.Enhanced computed tomography(CT) showed a lobule mass of 107 × 42 mm in size, with internal inhomogeneity and mild delayed enhancement on the retroperitoneal side of the left abdominal lesion. Magnetic resonance imaging(MRI) showed a mass with low intensity and partial high intensity on T2 weighted Image (T2WI). In addition, positron emission tomography CT(PET-CT) detected slight fluorodeoxyglucose (FDG) accumulation (standardized uptake value(SUV) max: 3.01) in the same lesion. Based on these findings, we suspected a retroperitoneal tumor. Laparoscopic excision was performed via 5 ports. The extracted tissue was a well-defined mass of 110 × 70 mm. The tumor in our case exceeded 10 cm.The pathological diagnosis was ganglioneuroma, with no obvious malignancy.DiscussionIt was suggested that adaptation of laparoscopic surgery should be considered based on the observation of organ invasion or vessel invasion and adhesion around the tumor, rather than based on the diameter of the tumor.ConclusionThis approach is less invasive than conventional laparotomy methods and achieves good cosmetic outcomes. Thus, totally laparoscopic procedures should be considered more often for the treatment of retroperitoneal tumors.     

Laparoscopic resection of a retroperitoneal cystic lymphangioma

The success of laparoscopic cholecystectomy has expanded the scope of laparoscopic procedures and resection of retroperitoneal organs and selected cystic intraadominal masses have been performed by minimally invasive surgical techniques. We report the case of a 45-year-old that presented a retroperitoneal cystic lymphangioma that was successfully excised by a laparoscopic approach. Laparoscopic surgical techniques should be considered for treatment of selected cystic lesions of intrabdominal or retroperitoneal origin.     

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.     

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.     

腹膜后囊性淋巴管瘤的诊断与治疗

目的探讨腹膜后囊性淋巴管瘤的诊断与治疗。方法收集经病理证实的成人腹膜后囊性淋巴管瘤7例,回顾性分析其临床特征及影像学表现,并与手术、病理结果对照。其中男2例,女5例,平均年龄51岁。患者均无特征性临床表现。超声及CT均表现为边缘光整的囊性肿块,病变大小约6cm×7cm～20cm×21cm,部分囊内有分隔,且壁与分隔可部分强化。术前诊断腹膜后囊性占位病变4例,腹腔囊肿2例,仅1例患者经CT引导下穿刺抽液确诊。结果7例均行手术治疗,完整切除肿瘤者6例,1例因肿瘤浸润肝脏及胰腺仅行大部切除。术后病理报告证实为:(腹膜后)囊性淋巴管瘤。7例随访9个月～10年,完整切除者均未见复发,大部切除者于术后5个月出现局部复发。结论超声及CT对腹膜后囊性淋巴管瘤定位、定性诊断具有重要价值,手术切除是治疗首选。     

腹膜后巨大囊性淋巴管瘤1例

病例:女,28岁,因左侧腰背部酸痛3月余入院。病程中无放射痛,无发热、乏力、纳差等。体检无血压升高、无贫血、黄疸,腹平软,未及明显肿块,无压痛,无肾区叩击痛;各项实验室指标包括血常规、肝肾功能、血糖、肿瘤标志物均正     

Infected retroperitoneal cystic lymphangioma masquerading as psoas abscess

A 2-year-old male is described who presented with fever, fixed flexion deformity of the right hip and a tender mass in the right iliac fossa. A clinical diagnosis of psoas abscess was made. Abdominal ultrasound was suggestive of an echogenic retroperitoneal cyst but could not accurately determine the nature of the cyst. A contrast CT scan showed a retroperitoneal cyst. At laparotomy, a large retroperitoneal cyst containing turbid fluid was found and was excised completely. Histopathological examination was suggestive of cystic lymphangioma. Clinical presentation of retroperitoneal lymphangioma may be variable and misleading, therefore complex imaging studies are necessary in the evaluation of this condition.     

Total laparoscopic excision of retroperitoneal ganglioneuroma using the hanging method and a vessel-sealing device

An 11-year-old girl presented with a homogeneous right retroperitoneal tumor 5 cm in diameter. Nonfunctioning benign neurogenic tumor was suspected, and a laparoscopic resection was performed. The inferior vena cava ran just behind the tumor, and there were small vessels between the tumor and inferior vena cava. To create a space behind the tumor, we suspended the tumor by using a traction suture, and to obtain adequate hemostasis, we used a vessel-sealing device. The tumor was safely removed and the pathological diagnosis was benign ganglioneuroma. The postoperative recovery was uneventful, and the patient left her bed and started a regular diet on the postoperative day 1. Laparoscopic surgery is a safe, feasible method for the diagnosis and treatment of benign retroperitoneal tumors, such as ganglioneuroma.     

Endoscopic ultrasound diagnosis and laparoscopic excision of an omental lymphangioma

Omental lymphangiomas are rare intra-abdominal tumors. We describe a case of an omental lymphangioma which appeared on computed tomography scan as a possible gastric duplication cyst. The lesion was correctly diagnosed preoperatively via endoscopic ultrasound and complete excision of the cyst was performed laparoscopically.     

Successful excision of an isolated mediastinal cystic lymphangioma with bilateral thoracoscopic surgery

Lymphangioma is a well-known benign tumor and its cystic abnormalities of the lymph vessels are predominantly congenital. Cystic lymphangioma usually occurs in the neck, axillary region, and rarely in the mediastinum, which frequently occurs in children and young adults. A 20-year-old woman had symptoms of palpitation, cough, and dyspnea during the recent 1 month. Both chest comuted tomography and magnetic resonance imaging of the chest revealed a well-defined, 13 × 10-cm cystic lesion in the anterior mediastinum. The patient underwent bilateral video-assisted thoracoscopic excision of the cyst and lymphangioma was confirmed based on histopathologic examination. Here, we report a rare case of isolated mediastinal cystic lymphangioma that was successfully excised using a minimally invasive technique.