Cystic lymphangioma of the jejunal mesentery in a young adult: a rare case report

Authors

  • Jignesh Rathod Department of Surgery, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India
  • Sujan Patel Department of Surgery, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India
  • Henil M. Upadhyay Medical Intern, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India

DOI:

https://doi.org/10.18203/2349-2902.isj20204706

Keywords:

Cystic lymphangioma, Jejunum, Small bowel mesentery

Abstract

Lymphangioma is an uncommon congenital malformation of the lymphatic system that manifest as a benign tumor. They are most commonly seen in children and rarely in adults. Lymphangiomas in the peritoneal cavity are extremely rare in adults, comprising of less than 1% of all lymphangiomas. We report a case of 18-year-old healthy female who was diagnosed with cystic mesenteric lymphangioma of the small intestine on CT scan as a part of her routine health check-up. CT scan reported a large well-defined cystic mass in mesentery of the small intestine filled with a hyper dense fluid. The lesion had thin capsule and internal septa. Radiological diagnosis was confirmed intra-operatively on laparoscopy. The patient underwent laparotomy with resection of the cyst and the involved jejunum segment followed by end to end anastomosis. The specimen was sent for histo-pathological examination and the findings were consistent with the diagnosis of cystic lymphangioma of the jejunal mesentery. Cystic mesenteric lymphangiomas are rare entities in a clinical setting that can be easily missed on clinical examination or may present as asymptomatic disease. CT scan is the gold standard investigation for diagnosis of mesenteric lymphangiomas. The preferred surgical approach depends on the location of the lesion, the clinical features and the spread of the lesion to surrounding structures.

Author Biographies

Jignesh Rathod, Department of Surgery, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India

Professor, Department of Surgery

Sujan Patel, Department of Surgery, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India

Post graduate Resident, Department of Surgery

Henil M. Upadhyay, Medical Intern, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India

Medical Intern

References

Okazaki T, Iwatani S, Yanai T, Kobayashi H, Kato Y, Marusasa T, et al. Treatment of lymphangioma in children: our experience of 128 cases. J Pediat Surg. 2007;42(2):386-9.

Hanagiri T, Baba M, Shimabukuro T, Hashimoto M, Takemoto H, Inoue A, et al. Lymphangioma in the small intestine: report of a case and review of the Japanese literature. Surg Tod. 1992;22(4):363-7.

Roisman I, Manny J, Fields S, Shiloni E. Intra‐abdominal lymphangioma. Brit J Surg. 1989;76(5):485-9.

Bang GA, Tolefac P, Fola O, Biyouma M, Bisay U, Guifo ML, et al. Giant sixteen kilogram lymphangioma mesenteric cyst: an unusual presentation of a rare benign tumour. International Journal of Surgery Case Reports. 2019 Jan 1;59:94-6.

Sham M, Kudrimoti J. Rare location of mesenteric cystic lymphangioma in an infant. J Clinic Neonatol. 2014;3(3):164.

Bhandarwar AH, Tayade MB, Borisa AD, Kasat GV. Laparoscopic excision of mesenteric cyst of sigmoid mesocolon. J Minim Acce Surg. 2013;9(1):37.

Chen J, Du L, Wang DR. Experience in the diagnosis and treatment of mesenteric lymphangioma in adults: a case report and review of literature. Wor J Gastrointest Oncol. 2018;10(12):522.

Hardin WJ, Hardy JD. Mesenteric cysts. The Americ J Surg. 1970;119(6):640-5.

Daniel S, Lazarevic B, Attia A. Lymphangioma of the mesentery of the jejunum: report of a case and a brief review of the literature. Americ J Gastroenterol. 1983;78(11).

Rieker RJ, Quentmeier A, Weiss C, Kretzschmar U, Amann K, Mechtersheimer G, et al. Cystic lymphangioma of the small-bowel mesentery. Pathol Oncol Resear. 2000;6(2):146-8.

Chen CW, Hsu SD, Lin CH, Cheng MF, Yu JC. Cystic lymphangioma of the jejunal mesentery in an adult: a case report. Wor J Gastroenterol. 2005;11(32):5084.

1Cupido BD, Low G. Incidental cystic lymphangioma of the small bowel mesentery. J Clinic Imag Sci. 2015;5.

Thiam O, Faye PM, Niasse A, Seye Y, Gueye ML, Sarr IS, et al. Cystic mesenteric lymphangioma: A case report. Int J Surg Cas Repor. 2019;61:318-21.

Davidson AJ, Hartman DS. Lymphangioma of the retroperitoneum: CT and sonographic characteristic. Radiol. 1990;175(2):507-10.

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Published

2020-10-23

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Case Reports