Review of diagnosis, differential diagnosis, and management of retroperitoneal lymphangioma

Hoang, Van Trung; Duc, Nguyen Minh; Van, Hoang Anh Thi; Hoang, Thanh D.

doi:10.1007/s11604-022-01356-0

Cited by 3 publications

(3 citation statements)

References 91 publications

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“…Cystic lymphangiomas are typically diagnosed before the age of 2 years in more than 90% of cases. 8 They do not communicate with the normal lymphatic network, 9 except in a few reported cases in the retroperitoneum 10,11 and contain clear lymph or chylous fluid. Lymphangiomas are histologically classified into three types, but the cystic type is of particular interest and is classified according to several parameters, including the lymphatic space of the tumor.…”

Section: Clinical Discussionmentioning

confidence: 99%

Rare case of inguinal cystic lymphangioma diagnosed and treated in elderly patient

Koubbach,

Rabii,

El Houry

et al. 2023

SAGE Open Medical Case Reports

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Cystic lymphangioma develops due to the interruption of lymphatic-venous connections during embryogenesis, leading to the formation of a cystic lesion containing lymph. These lesions fall under the ISSVA classification of vascular malformations. The first documented case dates back to 1828, with further elucidation provided by Sabin in 1909 and 1919. Cervicofacial region is the most common site, often showing early-stage symptoms. Inguinal location is rare, but if complications arise, it may present as a strangulated inguinal hernia. The tumor’s severity lies in its compression and invasion of the aerodigestive tract and adjacent organs. Diagnosis relies on imaging techniques such as ultrasound and computed tomography, which help determine the mass’s nature, boundaries, and relationship with neighboring structures. Asymptomatic lesions are generally monitored, while symptomatic ones require complete surgical excision to minimize the risk of recurrence. At Cheikh Khalifa University Hospital, we present a case highlighting our urology department’s experience in diagnosis, patient care, and surgical treatment.

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Section: Clinical Discussionmentioning

confidence: 99%

Rare case of inguinal cystic lymphangioma diagnosed and treated in elderly patient

Koubbach,

Rabii,

El Houry

et al. 2023

SAGE Open Medical Case Reports

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“…US is useful for diagnosing, visualizing multiloculated areas, and evaluating the complications [6]. Intraabdominal CLMs appears a hypoechoic cystic mass compartmentalized by intra-or inter-cystic echogenic septa [7].The properties of CLMs can be identi ed and be further categorized based on the diameter in centimeters under US images [8].Small vessels inside the septa and uid-uid levels associated with hemorrhagic or in ammatory complications can also be observed [9]. Nowadays, a fetal US is widely used to evaluate intra-abdominal cystic mass which provides obstetricians the opportunity to judge terminate pregnancy and provides pediatric surgeons the opportunity to intervene earlier.…”

Section: Nonementioning

confidence: 99%

“…CT provides more information regarding location, size, and the relationship between the lesions and the anatomical structure [10]. On CT images, CLMs appear as homogeneous density or heterogeneous density due to the presence of proteinaceous or blood within the lesions and form unilocular or multilocular cystic masses displace intra-abdominal organs and vessels [9].The septa or wall presents mild enhancement on enhanced contrast CT. Sedation is essential for younger children to complete CT examination, and simultaneously, patients would be exposed to radiation. MRI is the most informative imaging examination for evaluating anatomical extension and characterizing lesions, in particular in deep extension like intra-abdominal [11].Filled with uid inside, the lesion presents low signal intensity on T1-weighted images (WI) and high signal intensity on T2-WI with possible internal uid levels [12].Follow-up with MRI provides details to surgeon with post-operative complications and e cacy, which helps to identify the location cysts to be further injected.…”

Section: Nonementioning

confidence: 99%

Laparoscopic assisted sclerotherapy in pediatric intra-abdominal cystic lymphatic malformations

Shi

et al. 2023

Preprint

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Background Sclerotherapy is an effective treatment for CLMs of the head and neck. However, Management of intra-abdominal cystic lymphatic malformations(CLMs) remains debates. The purpose of this study was to examine safety and efficacy of laparoscopic assisted sclerotherapy for intra-abdominal CLMs in pediatric patients. Methods We retrospectively reviewed the patients treated with laparoscopic assisted sclerotherapy for intra-abdominal CLMs at a single tertiary medical center between July 2020 and July 2022.The basic information and clinical data of maximal diameter, dose, reduction of lesion’s volume and complications were analyzed. The efficacy was assessed by comparing the pre-operative and post-operative cross-sectional images. Results 7 patients were included in this study and underwent a total of 9 sclerotherapy sessions. 4 patients were symptomatic and majored in abdominal pain. The primary sclerotherapy did not response in better clinical outcome in 2 patients due to intra-cystic hemorrhage and additional procedure were performed. Lesions in 6 patients reduced ≥90% in volume which met the complete response criteria. No further complications were recorded during the follow-up. Conclusions Laparoscopic assisted sclerotherapy is a safe and effective method of managing intra-abdominal CLMs. Laparoscopy could localize the origin of lesions and provides more accuracy and stabilization during the injection procedure.

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A case report of lymphangioleiomyomatosis with retroperitoneal masses in pregnancy

Zhu,

Wang,

Ding

et al. 2023

Front. Med.

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BackgroundLymphangioleiomyomatosis (LAM) is a rare, gradually advancing tumor of unknown origin. It is distinguished by the anomalous proliferation of pulmonary smooth muscle cells and predominantly manifests in women of childbearing age. In this study, we aim to present a noteworthy case of LAM accompanied by lymphangioleiomyoma in the retroperitoneal space during pregnancy, a scenario susceptible to misdiagnosis.Case presentationA 31-year-old woman, facing an unintended pregnancy, presented during the 13th week with a cystic-solid mass exhibiting abundant blood signals in the pelvic cavity, as revealed by routine obstetrical ultrasound. Concurrently, her chest CT disclosed diffuse thin-walled cavities in both lungs. Despite the absence of clinical symptoms, the patient abandoned pregnancy and underwent a complete curettage. However, 24 days post-operation, she was readmitted for further assessment, revealing an enlargement of the mass encompassing the abdominal aorta and inferior vena cava, along with compression on the middle and lower segments of the ureter. After a multi-disciplinary discussion and patient explanation, an exploratory laparotomy was performed, resulting in the complete removal of the tumor. Intraoperative pathological examination and immunohistochemical staining indicated a retroperitoneal mass devoid of malignant evidence. The comprehensive morphologic and immunophenotypic features substantiated the diagnosis of lymphangioleiomyomatosis. The postoperative course was uneventful, culminating in the patient’s discharge.ConclusionThe consideration of Lymphangioleiomyomatosis (LAM) with a retroperitoneal tumor is crucial in the differential diagnosis of pelvic and abdominal masses. The preoperative diagnosis of this tumor poses a challenge, as ultrasound or CT scans may not yield definitive results. Accurate diagnosis necessitates not only a pathological examination of the retroperitoneal mass but also the correlation with the patient’s chest High-Resolution Computed Tomography (HRCT) findings and corresponding clinical manifestations. Optimal management involves radical surgery, with surgeons comprehensively factoring in both fetal and maternal conditions when formulating a treatment plan.

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Review of diagnosis, differential diagnosis, and management of retroperitoneal lymphangioma

Cited by 3 publications

References 91 publications

Rare case of inguinal cystic lymphangioma diagnosed and treated in elderly patient

Rare case of inguinal cystic lymphangioma diagnosed and treated in elderly patient

Laparoscopic assisted sclerotherapy in pediatric intra-abdominal cystic lymphatic malformations

A case report of lymphangioleiomyomatosis with retroperitoneal masses in pregnancy

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