Mesenteric cystic tumors are very rare. The incidence of the cystic lymphangioma, which belongs to this group, is even lower. Often it is mistakenly classified together with the chylous mesenteric cysts. The term "mesenteric cyst" is of a descriptive topographical nature, whereas the lymphangioma can be classified clearly by the histopathological findings. The lymphangioma typically appears in the first decade and when it is intra-abdominal it shows acute abdominal symptoms. Ultrasonography and computed tomography are very sensitive but not very specific examinations. The differential diagnosis of intra-abdominal lymphangioma includes many benign and malignant tumors. Therefore, a diagnosis is often first made during operation because of the macroscopic aspect and then definitely because of the histological examination. Differentiation between a mesenteric cyst and a cystic lymphangioma is important for the prognosis, because when there is a cystic lymphangioma with an incomplete resection, one has the danger of a recurrence with tendency to invasive growth. The therapy of choice is a complete radical resection. We report the case of an intra-abdominal lymphangioma and have studied the reports published about these tumors. We point out the clinical presentations, diagnosis, differential diagnosis and therapy of the lymphangioma.
Patient selection by a health fund, interdisciplinary assessment and severity adapted treatment resulted in significant reduction in pain and functional improvement in disabled back pain patients.
Our results support a satisfactory factorial and prognostic validity of the German short ÖMSPQ. The instrument may guide the provision of targeted interventions. Further research should link it to targeted treatments.
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