Cystic hygroma-lymphangioma: a rare and still unclear entity

Hygroma cysticum coli or cystic hygroma remains a complex entity in terms of its development and management. Most recently, cystic hygroma has been categorized as part of a larger spectrum that includes lymphangiomas. The majority of lymphangiomas occur in the head and neck as cystic hygromas with the posterior cervical region as the most common site. Since its original description, there have been many attempts at treatment modalities: surgical excision remains the treatment of choice. The literature is reviewed and 40 cases from the author's institution are presented. The purposes of this review are, first, to bring some order to the theories and development of this lesion and its various pathological presentations. Second, to approach the treatment of these difficult lesions in an objective manner and to set up guidelines for management.