Mediastino-hepato-renal cystic lymphangiomas-diagnostic and surgical considerations

Area of Science:

• Vascular Surgery
• Pediatric Surgery
• Oncology

Background:

• Cystic lymphangiomas (or hygromas) are rare, benign vascular tumors resulting from congenital lymphatic malformations.
• Typically presenting as neck or head swellings in children, they are infrequently found in the mediastinum or abdomen.
• Mediastinal cystic lymphangiomas can mimic other mediastinal tumors, presenting with symptoms like chest pain, dyspnea, cough, and dysphagia.

Observation:

• This report describes a unique case of a 71-year-old male with asymptomatic mediastinal, renal, and multiple hepatic cystic lymphangiomas.
• The patient presented with respiratory symptoms and significantly reduced lung capacity, which were attributed to the mediastinal mass.
• Diagnostic imaging modalities including CT and MRI provided information, but definitive diagnosis was confirmed post-surgical resection and histological examination.

Findings:

• Surgical excision of the mediastinal cystic lymphangioma led to complete regression of the patient's respiratory symptoms.
• Post-operative assessment revealed a significant increase in the patient's lung diffusion capacity.
• This case highlights the potential for cystic lymphangiomas to occur in extranodal sites in adults and present with atypical symptoms.

Implications:

• This case expands the known clinical spectrum of cystic lymphangiomas, particularly in adult patients.
• It underscores the importance of considering cystic lymphangiomas in the differential diagnosis of mediastinal masses, even in older individuals.
• The successful surgical management demonstrates the efficacy of intervention in improving respiratory function and quality of life for patients with these rare tumors.