Cystic Lymphangioma of the Mesocolon

Abstract

A 46-year-old gentleman presented to our hospital with a short story of abdominal pain and distension. On examination, gross ascites was noted and confirmed on subsequent imaging with no other notable features. CT scan after ascitic drainage showed a cystic mass extending from the lower pole of the spleen to the left iliac fossa in keeping with an intraperitoneal cyst. At laparatomy, a cystic lymphangioma was resected. Lymphangiomas are rare benign tumours and are reported to occur preferentially in the neck of axilla in children. Abdominal lymphangiomas are extremely rare particularly in adults but important to recognise due to a potential for serious consequences.

Sonographic findings in two cases of lymphangioma of the mesocolon in adults

“…The mesentery is made of connecting folds covered by peritoneum and is divided into the small bowel mesentery (jejunal mesentery and mesoileum) and mesocolon (ascending, transverse, descending, and sigmoid mesocolons and mesoappendix) . The majority of reported mesenteric lymphangioma cases involve the small bowel mesentery, and there are very few reports of mesocolic lymphangiomas in the English literature . Tsukada and coworkers reviewed 139 cases of mesenteric lymphangiomas documented in the Japanese literature from 1880 to 2000 and reported a male‐to‐female ratio of 3:2 and a child‐to‐adult ratio of 3:2 .…”

“…15 The majority of reported mesenteric lymphangioma cases involve the small bowel mesentery, [7][8][9][10][11][12] and there are very few reports of mesocolic lymphangiomas in the English literature. 13,14 Tsukada and coworkers reviewed 139 cases of mesenteric lymphangiomas documented in the Japanese literature from 1880 to 2000 and reported a male-tofemale ratio of 3:2 and a child-to-adult ratio of 3:2. 18 According to their review, the most frequent site was the small bowel mesentery (70.5%), followed by the mesocolon (26.2%).…”

“…Most cases of lymphangioma of the mesentery occur in children, and presentation in adulthood is relatively rare. Although representing less than 1% of all lymphangiomas, the majority of adult cases of mesenteric lymphangioma reported to date have developed from the small bowel mesentery, and there are very few adult cases of mesocolic lymphangioma in the English literature …”

“…Although representing less than 1% of all lymphangiomas, the majority of adult cases of mesenteric lymphangioma reported to date have developed from the small bowel mesentery, [7][8][9][10][11] and there are very few adult cases of mesocolic lymphangioma in the English literature. [12][13][14] We encountered two adult cases of pathologically confirmed mesocolic lymphangioma, one originating from the mesentery of the ascending colon and the other from the sigmoid mesocolon, treated with segmental resection of the affected mesentery and colon. In both cases, sonography (US) revealed a large multiloculated cystic mass involving the lower abdomen.…”

Single‐site laparoscopic excision of mesocolic cystic lymphangioma – a video vignette

“…Cystic lymphangioma (formerly cystic hygroma) is a benign tumour that is especially rare in the abdomen and retroperitoneum . Surgical resection when symptomatic is extremely uncommon, with most previous reported cases being by open laparotomy and only a few recent examples by multiport laparoscopy .…”