Robot-assisted laparoscopic removal of perirenal lymphangioma: a case report

The lymphangioma is a congenital malformation caused by abnormal development of the lymphatic vessels. The perirenal lymphangioma is extremely rare, and very few cases have been described in literature. A case of retroperitoneal perirenal lymphangioma is reported. Following recurring episodes of colic-like, right side back pain, a 16 year woman underwent an ultrasound which detected a multiloculated cystic lesion of 5 x 1 cm surrounding the lower pole of the right kidney. Subsequently a CT scan and an MRI detected, in the right perirenal space, a liquid multiloculated lesion, with no enhancement. Surgery was performed using the Da Vinci robotic system with transperitoneal access. Once dissection was concluded it was possible to identify a lymphatic duct coming from the renal pedicle, which likely drained the lesion, and selectively close it using clips. In conclusion, the cystic lymphangioma, must be considered among the differential diagnoses of retroperitoneal cystic lesions. These rare tumours have an excellent prognosis, with full remission of the symptomatology following complete surgical excision.