Cystic lymphangioma of the jejunal mesentery in a young adult: a rare case report

Abstract

Lymphangioma is an uncommon congenital malformation of the lymphatic system that manifest as a benign tumor. They are most commonly seen in children and rarely in adults. Lymphangiomas in the peritoneal cavity are extremely rare in adults, comprising of less than 1% of all lymphangiomas. We report a case of 18-year-old healthy female who was diagnosed with cystic mesenteric lymphangioma of the small intestine on CT scan as a part of her routine health check-up. CT scan reported a large well-defined cystic mass in mesentery of the small intestine filled with a hyper dense fluid. The lesion had thin capsule and internal septa. Radiological diagnosis was confirmed intra-operatively on laparoscopy. The patient underwent laparotomy with resection of the cyst and the involved jejunum segment followed by end to end anastomosis. The specimen was sent for histo-pathological examination and the findings were consistent with the diagnosis of cystic lymphangioma of the jejunal mesentery. Cystic mesenteric lymphangiomas are rare entities in a clinical setting that can be easily missed on clinical examination or may present as asymptomatic disease. CT scan is the gold standard investigation for diagnosis of mesenteric lymphangiomas. The preferred surgical approach depends on the location of the lesion, the clinical features and the spread of the lesion to surrounding structures.

Mesenteric cystic lymphangioma – A rare case report; National Center for Pediatric Surgery, Gezira State, Sudan; 2021

“…It is due to lack of lymphatic vascular connections; as a result of a developmental defect in the lymphatic system that leads to a sequestration of the lymphatic tissue. It is characterized by an abnormal dilatation and proliferation of lymphatic spaces [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Lymphangiomas are a group of vascular hamartomas, which result from a developmental failure in the vascular system, including lymphatic and/or arteries and veins.…”

“…The abdominal locations are variables, involving mesentery, mesocolon, retroperitoneum, omentum, splenic loge, liver and pancreas. MCLs are commonly cystic in nature [1,[3][4][5][6][7][8][9][10][11]14]. MCL has silent clinical course and therefore it's hard to be diagnosed.…”