Cystic hygroma and potential airway obstruction in a newborn: a case report and review of the literature

Abstract

BackgroundCervical cystic hygroma is a benign congenital malformation of the lymphatic system. Incidence of cystic hygroma is 1/6000 live births. We present a case of right neck mass with potential respiratory compromise in a newborn.Case presentationThe patient was a full term baby girl with an incidental finding of right neck mass which was described on ultrasound and magnetic resonance imaging as a cystic lesion in the nasopharynx and right neck which inferiorly followed the course of the right carotid artery, consistent with cystic hygroma. She started with respiratory compromise, and a follow-up magnetic resonance imaging showed increased size of the cystic hygroma. Dexamethasone was started to reduce fluid build up in the mass. When the cystic hygroma was found to be inseparable from the right half of the thyroid gland, the otolaryngologist performed hemithyroidectomy.ConclusionThe patient had neuropraxia involving the marginal mandibular branch of the facial nerve, which was expected to correct with time. Large cervical cystic hygromas may surround or displace neurovascular structures making their identification quite challenging intraoperatively. A team of experienced surgeons will help to ensure a successful surgical outcome.

A rare case of cystic hygroma in neck and extending into thoracic cavity

“…They are multilocular cysts filled with clear or yellow lymph fluid. Cystic hygromas may be associated with Turner syndrome, Noonan syndrome, trisomies, fetal alcohol syndrome, chromosomal aneuploidy, cardiac anomalies and fetal hydrops [ 7 ]. Cystic hygroma can be diagnosed based on radiographic appearance on MRI, biopsy (FNAC), and clinical symptoms [ 8 ].…”

An unexpected cause of stridor in a newborn

“…Cystic hygroma occurs in approximately 1/6000 live births, and situ of these lesions are predominantly in the neck region 1 2. They are usually detected prenatally or are externally visible after birth.…”

Endoscope-assisted excision of macrocystic lymphangioma in neck via anterior chest approach in infants and children

“…As the cyst increases in volume, and if infection or intracapsular hemorrhage occurs, the mass will swell and could potentially push onto the adjacent tissues and/or organs. Furthermore, airway pressure from the large mass was really life-threatening because of respiratory and circulatory failure [9,10], especially in infants and children.…”