Lymphatic Malformation of the Nasopharynx in a Young Pregnant Female: A Case Report

Abstract

Patient: Female, 21 Final Diagnosis: Lymphatic malformation of the nasopharynx Symptoms: Dysphagia Medication: — Clinical Procedure: Mass was localized in the nasopharynx and detached from a broad 1 cm stalk through both the oral and nasal approaches using bipolar cautery Specialty: Critical Care Medicine Objective: Congenital defects/diseases Background: Lymphangiomas represent the focal proliferation of benign, well-differentiated lymphatic tissue. They are most likely congenital, thus more commonly diagnosed at birth and before the age of 2 years. When they are found in adults, they favor the head, neck and axillary region. Rarely do they involve the nasopharynx region or occur in a pregnant patient. Case Report: A 21-year-old primagravida in the third trimester of pregnancy developed difficulty swallowing that progressed into difficulty breathing over a 1-month period. Imaging and examination suggested a benign mass in the nasopharynx and the patient underwent surgical removal of the stalk with bipolar cautery. The pathology report revealed a simple 4.5×1.5×0.8 cm lymphangioma. She had no fetal compromise during anesthesia. Conclusions: Surgical removal of a nasopharyngeal lymphangioma during the third trimester of pregnancy is indicated if respiratory obstruction may be a complication.

Retroperitoneal lymphangioma in a pregnant patient: A case report and literature review

“…The search identified 15 articles concerning pregnant women with lymphangiomas [ [1] , [2] , [3] , [4] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] ]. Five articles were excluded from the analysis: four due to postpartum diagnosis [ 3 , [6] , [7] , [8] ] and one due to pregestational diagnosis [ 9 ].…”

“…Lymphangiomas diagnosed during pregnancy were documented in both abdominal [ 2 , 4 , 10 , 14 , 15 , 16 ] and extra-abdominal [ 1 , [11] , [12] , [13] ] locations, most commonly in the gastrointestinal tract ( Table 2 ). Notably, none of the reported gestational lymphangiomas were located retroperitoneally.…”

“…Notably, none of the reported gestational lymphangiomas were located retroperitoneally. Diagnosis occurred in the second trimester in five cases [ 1 , 10 , 11 , 13 , 16 ], in the third trimester in three cases [ 4 , 12 , 14 ], and in the first trimester in only two cases [ 2 , 15 ]. De novo diagnosis of lymphangioma during pregnancy could be attributed to symptoms associated with larger lymphangiomas during gestation [ 10 , 12 , 13 ].…”

“…Diagnosis occurred in the second trimester in five cases [ 1 , 10 , 11 , 13 , 16 ], in the third trimester in three cases [ 4 , 12 , 14 ], and in the first trimester in only two cases [ 2 , 15 ]. De novo diagnosis of lymphangioma during pregnancy could be attributed to symptoms associated with larger lymphangiomas during gestation [ 10 , 12 , 13 ]. In our case, tumor growth was progressive, reaching over 18 cm in diameter during the second trimester, increasing to 25 cm in the third trimester, and reaching 30 cm by the time of surgical resection.…”

“…Symptoms varied depending on the anatomical location and size of the lymphangiomas. Abdominal pain was the most common presentation in abdominal lymphangiomas [ 10 , 13 , 14 , 15 , 16 ], while mass effect was predominant in extra-abdominal lymphangiomas [ 11 , 12 ]. Two patients were asymptomatic, with uterine and ovarian lymphangiomas found incidentally [ 2 , 4 ].…”