Cystic hygromas/lymphangiomas are extremely rare malformations in adults. They are usually seen in infants and children under 2 years of age. En bloc resection is difficult due to the adhesive characteristics of the tumours. Inadequate surgical intervention often leads to recurrent disease. We report herein the case of a cystic hygroma/lymphangioma that presented as an uncommon mass on the cervical region in an adult. A 24-year-old male presented with a swelling on the left side of the neck since childhood, noticed to have increased in size for the past six months. It was a solitary 4 cms x 3 cms, soft, non-tender, ovoid swelling at the left submandibular region with a well-defined margin with smooth surface and the overlying skin was normal. There was no intra-oral extension on bimanual palpation. The routine blood investigations are done and were within normal limits. FNAC and CT neck were done. Patient underwent wide excision, where the intraoperative findings showed a superficial cystic swelling with few loculi over the muscle layer of the mylohyoid and the anterior belly of the digastric with few finger-like extensions between the muscle planes. The swelling was excised in toto. Histopathology reports revealed multilocular cystic swelling lined by fibrous stroma and on microscopy was multiple lymph spaces lined by lymphatic epithelium with a diagnosis of lymphangioma of the neck. DISCUSSION OF MANAGEMENT Cystic hygromas/lymphangiomas are rare congenital malformations of the lymphatic system. Most are seen in the head and neck region (75-80%) and usually affect children under 2 years of age. 1 They are quite rare in adults. 2 The aetiology of hygromas in adults is controversial, but they are thought to be due to proliferation of lymphoid vessels in response to head and neck trauma and/or infection. 3
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