Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2023; 11(15): 3560-3570
Published online May 26, 2023. doi: 10.12998/wjcc.v11.i15.3560
Retroperitoneal cavernous hemangioma misdiagnosed as lymphatic cyst: A case report and review of the literature
Xiao-Fan Hou, Zhan-Xue Zhao, Lin-Xun Liu, Hao Zhang
Xiao-Fan Hou, Hao Zhang, Medical College, Qinghai University, Xining 810000, Qinghai Province, China
Zhan-Xue Zhao, Lin-Xun Liu, Department of General Surgery, Qinghai Provincial People's Hospital, Xining 810000, Qinghai Province, China
Author contributions: Hou XF contributed to manuscript writing and editing, and data collection; Zhao ZX contributed to data analysis; Liu LX contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Supported by Health Commission of Qinghai Province, No. 2020-wjzdx-28.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
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:
Corresponding author: Lin-Xun Liu, MD, Chief Physician, Doctor, Occupational Physician, Surgeon, Department of General Surgery, Qinghai Provincial People's Hospital, No. 2 Gonghe Road, Chengdong District, Xining 810000, Qinghai Province, China.
Received: January 29, 2023
Peer-review started: January 29, 2023
First decision: March 14, 2023
Revised: March 23, 2023
Accepted: April 14, 2023
Article in press: April 14, 2023
Published online: May 26, 2023

Primary abdominal and retroperitoneal cavernous hemangioma is a vascular tumor and rarely seen in the clinic. Due to the lack of specific imaging features, retroperitoneal cavernous hemangioma cannot be diagnosed accurately. Some symptoms may develop with the enlargement of lesion volume or the occurrence of complications such as rupture or oppression. We report here a special case who was admitted with chronic abdominal pain. Admission examination suggested a retroperitoneal lymphatic duct cyst. Laparoscopic resection of the retroperitoneal mass was performed, and histological examination confirmed retroperitoneal cavernous hemangioma.


The patient was a 43-year-old Tibetan woman with intermittent left lower abdominal pain and discomfort 3 years ago. Ultrasonography revealed a cystic mass in the retroperitoneum with clear boundaries, internal septa, and no blood flow signal. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an irregular space-occupying mass in the retroperitoneum, and retroperitoneal lymphatic cyst was considered. Plain CT scanning showed multiple cyst-like hypo-intense shadows in the retroperitoneum, partially fused into a mass, and no obvious enhancement was found on enhanced scanning. MRI showed multiple irregular clump-like long T1 and long T2 signal shadows above the pancreas, within which linear short T2 signal shadows were seen. Diffusion-weighted imaging sequence showed hypo-signal shadows, without obvious enhancement on enhanced scanning. Ultrasound, CT, and MRI all suggested the possibility of retroperitoneal lymphatic cyst. However, the patient was finally diagnosed with retroperitoneal cavernous hemangioma by pathological examination.


Retroperitoneal cavernous hemangioma is a benign lesion, and it is difficult to make a diagnosis preoperatively. Surgical resection may be the only treatment, which not only allows histopathological confirmation as a diagnostic purpose and excludes any risk of malignancy, but also avoids invasion of adjacent tissues, oppression, and other complications as a therapeutic goal.

Keywords: Cavernous hemangioma, Retroperitoneal, Diagnosis, Treatment, Case report

Core Tip: In this report, we describe a case of retroperitoneal cavernous hemangioma misdiagnosed as retroperitoneal lymphangioid cyst preoperatively.