Park JH, Lee D, Maeng YH, Chang WB. Surgical excision of a large retroperitoneal lymphangioma: A case report. World J Clin Cases 2022; 10(31): 11561-11566 [PMID: 36387812 DOI: 10.12998/wjcc.v10.i31.11561]
Corresponding Author of This Article
Won-Bae Chang, MD, Assistant Professor, Department of Surgery, Jeju National University Medical Center, 15, Aran 13-gil, Jeju-si 63241, Jeju-do, South Korea. wbchangmd@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 6, 2022; 10(31): 11561-11566 Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11561
Surgical excision of a large retroperitoneal lymphangioma: A case report
John Hee Park, Donghyoun Lee, Young Hee Maeng, Won-Bae Chang
John Hee Park, Department of Surgery, Samsung Medical Center, Seoul 06351, South Korea
Donghyoun Lee, Department of Surgery, Jeju National University Hospital, Jeju-si 63241, Jeju-do, South Korea
Young Hee Maeng, Department of Pathology, Jeju National University Medical Center, Jeju-si 63241, Jeju-do, South Korea
Won-Bae Chang, Department of Surgery, Jeju National University Medical Center, Jeju-si 63241, Jeju-do, South Korea
Author contributions: Park JH and Lee D contributed equally to this work. Chang WB, Lee D involved in the conceptualization; Lee D and Park JH contributed to the formal analysis; Park JH involved in visualization; Park JH and Lee D wrote the original draft; Chang WB reviewed and edited the manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case and accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Won-Bae Chang, MD, Assistant Professor, Department of Surgery, Jeju National University Medical Center, 15, Aran 13-gil, Jeju-si 63241, Jeju-do, South Korea. wbchangmd@gmail.com
Received: June 29, 2022 Peer-review started: June 29, 2022 First decision: August 1, 2022 Revised: August 23, 2022 Accepted: October 9, 2022 Article in press: October 9, 2022 Published online: November 6, 2022
Abstract
BACKGROUND
Lymphangiomas are rare benign tumors most commonly found in children under 2 years of age; adult cases are extremely rare. Retroperitoneal lymphangiomas represent less than 1% of all lymphangiomas. Because of their benign nature and possibility of spontaneous resolution, lymphangiomas are sometimes left untreated for long periods of time. However, if they grow large enough to compress surrounding structures, retroperitoneal lymphangiomas may cause symptoms such as abdominal pain, nausea or vomiting. We report a case of a rapidly growing retroperitoneal lymphangioma in an adult, treated with complete surgical excision.
CASE SUMMARY
A 60-year-old female who was diagnosed with an intra-abdominal cystic mass (11 cm × 9.5 cm) seven years ago presented to our hospital with symptoms of early satiety, nausea, and intermittent abdominal pain. Computed tomography (CT) scan confirmed interval enlargement to a 24 cm × 22 cm-sized huge left retroperitoneal mass, causing left hydronephrosis by external compression. Laparotomy was done via long midline incision. Due to severe adhesion between the aorta and the medial border of the mass, the cyst was intentionally opened for fluid aspiration and size reduction. After suture closure of the opening, we proceeded carefully with dissection. Aspiration showed light yellowish serous fluid. The mass was excised completely, and the pathology was consistent with cystic lymphangioma. The post-operative period was uneventful, and the patient was discharged without complications. Follow-up CT scan one month after surgery confirmed complete removal of the mass and decreased left hydronephrosis.
CONCLUSION
Excision of the huge retroperitoneal cystic mass resulted in relief of the patient’s symptoms, originally caused by external compression, and also ruled out the possibility of malignancy.
Core Tip: This is a rare clinical case which is related to the surgical excision of giant retroperitoneal lymphangioma. This mass which grew up to 24 cm diameter to compress surrounding structure caused symptoms such as abdominal pain, nausea, vomiting, and left hydronephrosis by compressing the left ureter and pelvis. We also could rule out the possibility of malignancy by pathologic study of excised specimen. This article presents the largest retroperitoneal lymphangioma treated with complete surgical excision in South Korea, compared to previous literature.
