Surgical excision of giant axillary cystic lymphangioma: a case report

Cystic lymphangiomas are rare benign congenital malformations of the lymphatic system, usually diagnosed in childhood and rarely encountered in adults. Axillary involvement in adults is particularly uncommon and presents diagnostic and surgical challenges owing to proximity to neurovascular structures.

This report describes a case of a 22-year-old Yemeni female patient presenting with localized pain in the left breast and a progressively enlarging tender axillary swelling. Imaging revealed a unilocular, thin-walled cystic lesion measuring 13 × 8 cm, extending into the subpectoral space and closely abutting the axillary vessels without invasion. Complete excision was performed via a curvilinear axillary incision, requiring meticulous adhesiolysis to preserve neurovascular integrity. Histopathology confirmed cystic lymphangioma. The postoperative course was uneventful, and no recurrence was noted at 5 month follow-up.

Although predominantly a pediatric entity, cystic lymphangioma should be considered in the differential diagnosis of adult axillary masses. Preoperative imaging is crucial for surgical planning, and complete surgical excision offers excellent outcomes with minimal functional impairment.