Cystic hygroma is a rare congenital malformation of the lymphatic system. In most centers, surgical excision is considered to be the optimal mode of treatment. Spontaneous resolution of cystic hygroma was briefly described in the literature with unsatisfactory results. Between 1970 and 2003, 14 patients were diagnosed to have cystic hygroma (13 cervical and 1 axillary). A retrospective review was performed. All patients were treated successfully with aspiration alone with a mean follow-up time of 5.75 years. Three patients needed multiple aspirations (average 1.66) with complete resolution. Complications were limited to one case of infection treated with antibiotics with no residual problems. Conservative management of cystic hygroma is a reliable mode of treatment with a low complication rate. Intralesional sclerosant injection and surgery should be reserved for other forms of lymphatic malformations.
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