Varied Presentation and Management of Lymphangiomas in Infancy and Childhoodour Experience in District Level Teaching Hospital

Abstract

Lymphangiomas are developmental defects of the lymphatic channels that belong to a large spectrum of vascular malformations usually located in the head and neck region. They present variedly and occur anywhere there are lymphatic vessels. These are seen in infants and children primarily. Retroperitoneal lymphangiomas pose diagnostic challenge as well as its surgical management. OBJECTIVEOur study focused on the location, clinical presentation, and management of lymphangiomas in infancy and childhood. METHODSThe medical records of children with lymphangiomas admitted to MGM Hospital, Warangal, Telangana State over a period of 7 years from April 2009 to March 2016 were reviewed for age with gender, location, mode of presentation, management, and its outcome. RESULTSWe managed 50 children with lymphangioma in last 7 years at MGM Hospitals, Warangal. The age range from 9 days to 10 years. About 65% of children were in the age group of less than 5 years with female-to-male ratio of 2:1. The youngest was 9 days and the eldest was 10 years. In 20 patients (40%), lymphangioma was present in the neck, 18% in axilla (9 patients), 10% in over the chest wall/abdominal wall, 10% over the back, 10% over the limbs (5 patients each) respectively, 8% over the perineal region (4 patients), 2% in retroperitoneum (1 patient), and 2% in the floor of the mouth (1 patient). Surgical excision was the treatment of choice and performed in all cases. CONCLUSIONSLymphangiomas are rare congenital malformations seen in infancy and childhood. They are usually asymptomatic at the time of clinical presentation. They are diagnosed by ultrasonography. CT and MRI scan are performed in doubtful cases. Total or subtotal excision was the treatment of choice by preserving the surrounding important structures.