Clinical Analysis of Intraperitoneal Lymphangioma

Abstract

Background:Intraperitoneal lymphangioma (IL) used to be thought of as a benign lymphatic malformation with a low rate of preoperative diagnosis. This retrospective study aimed to explore the connection between the cysts and clinical manifestation and imaging characteristics, and to study diagnostic confusion, therapeutic principles and potential recurrent reasons, to further enhance the comprehension of this rare disease.Methods:Here, we retrospectively reviewed 21 patients diagnosed with IL. Age, sex, complaints, physical findings, and imaging features of each patient were documented. The therapies, postoperative complications and treatments were discussed.Results:Symptomatology included eight patients (38%) with intermittent dull pain in the abdomen, and three patients (14%) complained of abdominal persistent pain. The physical examination revealed an abdominal mass in 16 patients (76%), and eight (38%) were reported no discomfort. IL was correctly established preoperatively in 19 patients (90%). Patients were treated using laparotomy, except one who was treated with laparoscopy. Two recurrences were noted during follow-up.Conclusions:IL should be suspected in any patient with a mobile abdominal mass and surgery is required immediately after discovery of the tumor.

Laparoscopic-assisted excision of a huge polycystic omental lymphangioma in a 3 year old patient presenting with acute abdomen: case report and review

“…They can be classified into three types: 1) capillary; 2) cavernous and 3) cystic, which is also known as cystic hygroma [ 5 ]. Abdominal lymphangiomas are mostly cystic, but can be cavernous [ 7 ], comprising less than 5% of all lymphangiomas in children [ 3 ]. The incidence of mesenteric and omental cysts is around 1 in 20,000 children [ 4 ], with the latter accounting for up to 2.2%.…”

“…Omental lymphangiomas are rare abdominal malformations that due to the capacity of the abdominal cavity to expand do not develop symptoms early, unless complications arise [ 7 ]. Ultrasonography combined with an abdominal CT scan lead to a diagnostic accuracy of up to 90% according to Li et al .…”

“…Ultrasonography combined with an abdominal CT scan lead to a diagnostic accuracy of up to 90% according to Li et al . [ 7 ]. The same diagnostic approach was also followed in our case, though a definite diagnosis was possible only after the laparoscopic exploration due to the atypical symptoms and imaging resemblances with other conditions (e.g.…”

“…Lymphangiomas generally are known to have high recurrence rates after excision. In a case series study, a postoperative recurrence rate of 10% was noted, probably due to incomplete resection [ 7 ], while lymphangiomas have an aggressive biological behavior often invading adjacent organs and structures, contradicting their otherwise benign nature [ 5 ]. Consequently, in some cases, segments of nearby tissues (e.g.…”

“…bowel) might be necessarily excised to avoid recurrence, except for cases when prohibitive factors coexist, such as great proximity to vital organs or infiltration of large segments of vital organs that might compromise function [ 4 , 7 ]. Nevertheless, the reported success rate for complete excision is from 82% to 95% for abdominal lesions and only 55% for retroperitoneal lesions [ 2 , 7 ]. It is important to mention that in regards to the current literature none of the recurrence incidents were observed in cases of omental lymphangiomas but rather in other intraperitoneal or retroperitoneal lymphangiomas.…”