Recurrent cystic lymphangioma of the neck. Case report

Cystic lymphangioma is a rare benign tumor commonly located in the head or neck. Approximately 100 adult cases have been reported in the literature. The etiopathogenesis is unclear, though trauma has been suggested as one of the possible causes.

We report a case of recurrent cystic lymphangioma arising in an adult who had been successfully treated in our department, leading us to review the literature for a critical examination of our therapeutic choices and the pathological, clinical and therapeutic aspects. We performed a dissection of the cyst respecting anatomical structures.Three days after the surgery, the patient showed a recurrence under the previous site of the excision, We then decided to place a suction drainage under local anesthesia, The suction drainage was removed 25 days later.The post-operative course of the patient showed no signs of recurrence for twenty-four months.

Complete surgical excision is the treatment of choice in symptomatic patients. In our experience, postoperative suction drainage improved the outcome. Some authors have come out in favor of experimental, non-surgical methods, such as percutaneous sclerotherapy, which they claim offer the most promising results.

In our experience, totally excision of the mass was the treatment of choice but, placing just one suction drainage for weeks for new recurrence resulted in a surprising outcome. In fact, recurrence usually appears within the first nine months in about 10-15% of patients.