Rare case of a solitary huge hepatic cystic lymphangioma

Abstract

A hepatic lymphangioma is a rare benign neoplasm and is usually associated with lymphangiomas of other viscera. A hepatic lymphangioma can be solitary, cystic or associated with multiple liver lesions and is characterized by cystic dilatation of lymphatic vessels in the hepatic parenchyma. A solitary lymphangioma is unusual. Here we report a rare case of a solitary huge primary hepatic cystic lymphangioma in a 42-year-old woman. It was discovered on routine physical examination and the patient had no obvious symptoms. Ultrasonography and computed tomography (CT) showed a giant "hepatic neoplasm" that occupied the right liver lobe. The lesion was approximately 20.0 cm × 15.0 cm × 10.0 cm in size and contained cystic and solid components. There were multiple septa inside the tumor, with some calcifications in the septa. Surgical resection was performed. Histological examination revealed multiple cystic structures lined with epithelial cells on the inner walls, accompanied by interstitial swelling and necrosis. The patient has now been followed up for nearly two years after surgery, with no recurrence to date.

Case report of solitary giant hepatic lymphangioma

“…Hepatic lymphangiomas are characterized by cystic dilatation of the lymphatic vessels in the hepatic parenchyma filled with lymph fluid, and are unilocular or multilocular in appearance. 1 2 3 4 The diagnosis in our case was ultimately found to be the cystic type. The histological features of cystic lymphangiomas include the following: flat endothelial lining of the cyst rather than cuboidal epithelium; lymphoid aggregates in the cyst wall; and smooth muscle in the cyst wall.…”

“…Lymphangiomas are generally considered to be congenital malformations of the lymphatic system, and they occur mostly in the neck, mediastinum and retroperitoneum; they are seldom found in the liver. 1 2 3 4 5 6 …”

“…Most hepatic lymphangiomas usually have a non-specific clinical presentation such as vague abdominal pain or mass of the affected side. 1 2 3 4 The major complaints were related to the compression of surrounding structures by the large lesion. In our case, the patient suffered from sudden pain in the right abdomen, which is considered to be a localized peritoneal sign of cystic fluid leakage from the tumor.…”

Solitary hepatic lymphangioma mimicking liver malignancy: A case report and literature review

“…Lymphangiomas are rare benign masses characterized by dilated lymphatic vessels, usually resulting from blockade of lymphatic reflux or abnormal development of the lymphatic system in embryogenesis[ 1 - 4 ]. The lymphatic system and venous system lack communication, which leads to the malformation of lymphatics.…”

Rare case of retroperitoneal cystic lymphangioma in an adult

“…1 Lymphangiomas being benign congenital malformation of lymphatic system are usually diagnosed in children and young adults and mostly located in head, neck and axilla where the loose connective tissue surrounding the structures allow lymphatic channels to expand and assume large proportions. [2][3][4] Less than 5% of all lymphangiomas occur intra-abdominally and of them <1% occur in the retroperitoneum. 5 When present intraabdominally they generally present as diffuse lymphangiomatosis involving multiple organs such as liver, kidney, spleen, GI tract mesentery , mediastinum, bones and soft tissue.…”