Retroperitoneal lymphangioma: A report of 2 cases and a review of the literature regarding the differential diagnoses of retroperitoneal cystic masses

Abstract

Abstract. Cystic lymphangioma is a type of benign tumor originating from the lymph vessels. The tumor commonly occurs in childhood, in the head or neck regions, and retroperitoneal localization and presentations in adulthood are rare. Determining a pre-operative diagnosis is often challenging, and in the majority of cases, a diagnosis is only possible subsequent to the histological examination of the surgical specimen. A radical resection is the recommended treatment for cystic lymphangioma, and recurrence is usually due to an incomplete excision of the mass. The present study reports 2 cases of cystic lymphangioma, localized in the pancreatic gland and duodenal wall respectively, which were treated with surgical resection. The study also briefly reviews the literature regarding the differential diagnosis of retroperitoneal cystic masses.

A Huge Cystic Retroperitoneal Lymphangioma Presenting with Back Pain

“…Lesser sac lymphangioma was reported to mimic acute appendicitis [21]. Such rare clinical manifestations as anemia and back pain have also been reported [22–24]. Our patient first noticed left-sided back pain during 2-3 months which emerged probably due to enlarging mass compressing retroperitoneal tissues.…”

Retroperitoneal lymphatic malformation: a case report

“…3 Children can present earlier with abdominal distension or pain. 4 Majority of patient are asymptomatic and findings are incidental during scan for other reasons. 6 Ultrasonography is the modality of choice in the initial assessment and evaluation of the morphology, location, vascularity of the lesion.…”

“…The tissue assessment post surgical excision is virtually diagnostic of lymphangioma and shows cystic spaces lined with a single thin layer of endothelium, lymphoid tissue and smooth muscles. [4][5][6][7][8] However excision was deferred in this case due to involvement of mesenteric vessels and multiple compartments. Interventional radiology was opted to help in reducing the size of the lesions by attempting multiple Sclerotherapy sessions.…”

“…1 Most of the patients are asymptomatic, however minority may present with abdominal distension or pain, intestinal or uretric obstruction or hematuria, cyst infection or hemorrhage. [2][3][4] The cases usually present in the first two years of life and the initial investigation include ultrasound which shows multicystic lesion crossing multiple compartments. Retroperitoneal extension is better assessed by CT scan or MRI studies.…”

“…1,5 The radical surgical excision is still by far the treatment of choice with low recurrence rate and less complications. 1,4,5…”