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Uncommon Presentation of a Macrocystic Lymphatic Malformation in a Seven-Year-Old Boy: A Case Report
Gopika Prasad1, Mc Enroe D Mordom2, Sanket R Shah3
1Pediatrics, LLH Hospital, Abu Dhabi, ARE.
Insights
Macrocystic lymphatic malformations, rare in children, can mimic common infections. This case shows antibiotics resolving a neck mass, indicating secondary infection as a cause for sudden swelling.
Area of Science:
- Pediatric Medicine
- Medical Imaging
- Surgical Pathology
Background:
- Macrocystic lymphatic malformations (MLMs), previously termed cystic hygromas, are rare congenital vascular anomalies.
- They typically manifest in early childhood, often presenting as cervical neck masses.
- Cervical masses in children are frequently attributed to infectious or inflammatory lymphadenopathy, overshadowing rarer causes.
Abstract:
Macrocystic lymphatic malformations (old terminology: cystic hygromas) are considered a relatively rare condition; they mostly appear in the first two years of life. Cervical neck masses are a common presenting complaint in children to pediatric outpatient departments, the most common causes being infectious/inflammatory conditions of cervical lymph nodes. In this report, we aim to bring light to the fact that rarer causes like secondarily infected or hemorrhagic lymphatic malformations may also present similarly. Here, we present the case of a seven-year-old boy who had been asymptomatic before, presenting with a 10-day history of sudden-onset neck swelling associated with an upper respiratory tract infection. Treating the upper respiratory tract infection with an oral antibiotic also helped the cystic mass involute, showing that a secondary infection was the precipitating factor in the sudden increase in size of the cyst. Management options for these lymphatic malformations are between sclerotherapy and surgical excision according to indications. In this case, the size has resolved considerably with antibiotics so that the child does not require an active intervention at present and is planned to be under close radiological follow-up.