Inguinal prolapse of a retroperitoneal lymphovascular malformation

Abdominal lymphovascular malformations (ALMs) are rare cystic masses that can present with nonspecific symptoms. We present a case of a 7-month-old boy who, during an uncomplicated communicating hydrocele repair, was found to have an incidental large, prolapsed mesenteric abdominal lymphovascular malformation. The case serves to highlight the variability in presentation and natural history of ALMs, and the ease with which they can be disguised by more common pathology. We further underscore the importance of individualized therapy with regards to ALMs, emphasized by our course of active surveillance allowing our patient to avoid ionizing radiation and additional surgical intervention.