[Giant cystic lymphangioma of the small bowel mesentery]

Mesenteric cystic lymphangiomas are benign tumors, considered surgical rarities. They can develop from the duodenum to the rectum, on the entire mesentery surface. The preoperative diagnosis is difficult because they can mimic a wide range of tumors. The treatment of choice is surgery and diagnosis is confirmed by histopathological examination. A 57-year-old male patient was admitted to the 2nd Surgery Clinic from Târgu Mureş, after a control ultrasonography examination incidentally highlighted a tumor mass at the mesenteric level and the growth of the tumor volume was observed. The preoperative CT scan presented a cystic mass adjacent to the jejunal loops, at a distance of 65 mm from the Treitz angle, measuring 75 × 100 × 92 mm with a volume of 430.24 cm3. During surgery total enucleation of the mesenteric cyst was performed. The cystic wall presented yellowish color and the fluid content had a milky white appearance. Histopathological examination confirmed the diagnosis of cystic lymphangioma. The immunohistochemical profile presented positive reaction of endothelial cells with CD34, CD31, podoplanin, and negative reaction with CK AE1/AE3 and CK7. The patient was discharged after 7 days following the surgical intervention. No recurrence was highlighted during the 12 months of follow-up. In most cases, the diagnosis of mesenteric cystic lymphangioma is made incidentally. During imaging investigations, they can mimic multiple malignant lesions. The gold standard of treatment is radical resection which ensures also recurrence prevention and a good prognosis. Orv Hetil. 2026; 167(20): 798-804.