Multiple intestinal lymphangiomas with episodic hemorrhage requiring partial laparoscopic resection: a case report

Area of Science:

• Gastroenterology
• Surgical Oncology
• Vascular Anomalies

Background:

• Lymphangioma is a rare, non-epithelial tumor characterized by dilated lymphatic aggregates.
• Mesenteric lymphangiomas are exceptionally rare, accounting for less than 1% of all cases and rarely involving the gastrointestinal tract.
• While typically affecting children, lymphangiomas can rarely occur in adults, presenting with nonspecific symptoms.

Purpose of the Study:

• To describe a rare case of multiple intestinal lymphangiomas in an elderly adult presenting with anemia and bleeding.
• To highlight the diagnostic challenges and successful management of adult gastrointestinal lymphangiomas.
• To emphasize the importance of considering lymphangiomas in the differential diagnosis of unexplained anemia and hypoalbuminemia in adults.

Main Methods:

• A case presentation of an elderly Japanese woman with anemia, hypoalbuminemia, and bleeding.
• Diagnostic imaging included abdominal computed tomography (CT) and magnetic resonance imaging (MRI).
• Single-balloon enteroscopy was used for lesion identification and tattooing, followed by laparoscopy-assisted resection.

Main Results:

• The patient presented with anemia, hypoalbuminemia, and episodic gastrointestinal bleeding.
• Imaging revealed multiple mesenteric low-density defects consistent with lymphangiomas.
• Successful resection of a bleeding hemolymphangioma via laparoscopy-assisted surgery controlled hemorrhage, with the patient remaining stable postoperatively.

Conclusions:

• Mesenteric and gastrointestinal lymphangiomas, though rare in adults, should be considered in patients with anemia and hypoalbuminemia.
• Surgical resection, even if limited to symptomatic lesions, can effectively improve patient outcomes.
• This case underscores the importance of a high index of suspicion for rare gastrointestinal tumors in adult patients with relevant clinical presentations.