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Tumor Discovery Adult cystic hyroma

very rare . Surgical excision is the choice of treatment as 3. Discussion
[8]
described in most literature .
[9]
The incidence of lymphangiomas is in the range of
[10]
2. Case presentation 1.2 – 1.8/1000 of new births or 1 in 2000 – 4000 live
births , as reported in different studies. It has been found
[11]
A young female of age 27 years with no co-morbidity with that in 90% of reported cases, the lesion occurs commonly
Eastern Cooperative Oncology Group Performance Status in the age range between birth and 2 years . The most
[12]
1 approached our clinic and complained of right side common site or origin of lymphangiomas is the head and
neck swelling. There was no supportive family, medical neck region . The other reported sites of lymphangiomas
[13]
and surgical history. The patient has a history of swelling with the lower incidence rate are retroperitoneum, axilla,
on the right side of the neck around 2 years ago, and the pelvis, and mediastinum [14,15] . Out of all head and neck
swelling gradually grew (in size) over the years. There was lymphatic malformations, cystic hygroma accounts for the
mild pain with the movements of the neck. There was no majority with an accountability of 75% in the head and
associated history of trauma, difficulty in swallowing, and neck region . The causes of lymphatic malformations
[16]
previous procedure. During clinical examination, there are still unclear; however, some of the etiologies have been
was mobile and fluctuating large swelling of approximately reported like misplacement of lymphatic channels during
10 cm × 9 cm in size, which was present in the right posterior embryogenesis, arrest of lymphatic growth, and failure
triangle of the neck without neck lymphadenopathy. She had of lymphatic system to reach the venous drainage . In
[17]
been evaluated outside of our clinic with contrast-enhanced addition, an association has been found between cystic
computed tomography (CECT) of the neck and fine needle hygroma and other conditions such as chromosome
[18]
aspiration cytology (FNAC), and we also had advised her aneuploidies, hydrops fetalis, and intrauterine death .
to undergo computed tomography (CT) of the chest. The The most common presentation of cystic hygroma is a
finding of CECT was suggestive of a multiseptated cystic painless and ill-defined swelling or mass. It never involves
lesion of 10.5 cm × 9.5 cm × 8 cm in the posterior triangle skin and it shows positive transillumination test. The
of right side of the neck with preservation of all fat planes, as common location of cystic hygroma is in the anterior and
shown in Figures 1 and 2. Meanwhile, the finding of FNAC posterior triangles of the neck, with the posterior triangle
was suggestive of lymphangioma, which was probably cystic of the neck being the most common site of occurrence .
[19]
hygroma. The patient was advised to undergo surgery, and Some of the cystic hygromas present with large neck masses
she was treated with wide local excision with intact capsule with obstructive symptoms such as dysphagia or adult
(Figures 3 and 4). The post-operative course was uneventful, respiratory distress if they are located in the suprahyoid
and she was discharged on the 5 post-operative day. The region, and these lesions are associated with a higher rate
th
final histopathology report confirmed that the cystic lesion of recurrence, complications, and morbidity . Incomplete
[20]
was a cystic hygroma. Recurrence was not reported by the surgical resection, midline location, and multiple lesions
patient even after 1 year of completion of treatment. are in favor of higher recurrence rate. Hence, complete

Figure 1. Coronal view of contrast-enhanced computed tomography.

Volume 1 Issue 2 (2022) 2 https://doi.org/10.36922/td.v1i2.151