Cystic lymphangioma of breast and axillary region in an adult: a rare presentation

Samir Shukla, Rahul Shivhare, Vikas Lal, Deepak Rathore


Cystic lymphangioma also known as cystic hygroma, is a congenital malformation of lymphatic system. Most lymphangioma are present at birth and are diagnosed by the age of 2 years. They are usually located in the head and neck region and are rare in other location. We are reporting a case of cystic lymphangioma in breast and axillary region in a 23 years old female. Physical examination revealed a non-tender cystic mass in axilla and upper outer quadrant of left breast. Ultrasonography (USG) revealed a hypoechoic mass lesion and magnetic resonance imaging (MRI) showed a multi-spectated cystic mass in left axilla closely involving the left breast parenchyma. Wide local excision was done and histopathological examination further confirmed the diagnosis of cystic lymphangioma. Although it is very rare, cystic lymphangioma should be considered in the differential diagnosis of mass in breast and axillary region.


Lymphangioma, Cystic, Breast, Axilla

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Gow L, Gulati R, Khan A, Mihaimeed F. Adult-onset cystic hygroma: a case report and review of management. Grand Rounds. 2011;11(1):5-11.

Bloom DC, Perkins JA, Manning SC. Management of lymphatic malformations. Curr Opin Otolaryngol Head Neck Surg. 2004;12:500-4.

Naidu SI, McCalla MR. Lymphatic malformations of the head and neck in adults: a case report and review of the literature. Ann Otol Rhinol Laryngol. 2004;113:218-22.

Sarin YK. Cystic hygroma. Indian Pediatr. 2000;37:1139-40.

Perkins JA, Manning SC, Tempero RM, Cunningham MJ, Edmonds JL, Hoffer FA. Lymphatic malformations: review of current treatment. Otolaryngol Head Neck Surg. 2010;142:795-803.

Adams MT, Saltzman B, Perkins JA. Head and neck lymphatic malformation treatment: a systematic review. Otolaryngol Head Neck Surg. 2012;147(4):627-39.

Philippakis GE, Manoloudakis N, Marinakis A. A rare case of a giant cavernous lymphangioma of the chest wall and axilla in an adult patient. Int J Surg Case Rep. 2013;4(2):164-6.

Krainick-strobel U, Krämer B, Walz-Mattmüller R, Kaiserling E, Rohm C, Bergmann A. Massive cavernous lymphangioma of the breast and thoracic wall: case report and literature review. Lymphology. 2006;39(3):147-51.

Michail O, Michail P, Kyriaki D, Kolindou A, Klonaris C, Griniatsos J. Rapid development of an axillary mass in an adult: a case of cystic hygroma. South Med J. 2007;100:845-9.

Stoss S, Kalbermatten DF, Robertson A, Bruder E, Rasmus M, Gambazzi F. Large cystic tumour at the chest wall mimicking an echinococcosis: a case report. J Plast Reconstr Aesthet Surg. 2008;61:13-6.

Nguyen K, Karsif K, Lee S, Chorny K, Chen M. Lymphangioma in an elderly patient: an unusual cause of axillary mass. Breast. 2011;17:416-26.

Gebrim LH, de Lima GR, Tanaka CI. Axillary cystic lymphangioma in pregnancy. Int J Gynaecol Obstet. 1995;48:327-8.

Katharina C, Quack L, Abdul-Raham J, Elisabeth G, Judit P, Ernst B. Axillary cavernous lymphangioma in pregnancy and puerperium. Gynecol Obstet Invest. 2005;60:108-11.

Smith RC, Sherk HH, Kollmer C, Javitt MC. Cystic lymphangioma in the adult: an unusual axillary mass. Magn Reson Imaging. 1989;7:561-3.

Schefter RP, Olsen KD, Gaffey TA. Cervical lymphangioma in the adult. Otolaryngol Head Neck Surg. 1985;93(1):65-9.

Kennedy TL, Whitaker M, Pellitteri P, Wood WE. Cystic hygroma/lymphangioma: a rational approach to management. Laryngoscope. 2001;111(11):1929-37.

Smith RJ, Burke DK, Sato Y, Poust RI, Kimura K, Bauman NM. OK-432 therapy for lymphangiomas. Arch Otolaryngol Head Neck Surg. 1996;122(11):1195-9.

Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg. 1982;69(3):412-22.

De Serres LM, Sie KC, Richardson MA. Lymphatic malformations of the head and neck. A proposal for staging. Arch Otolaryngol Head Neck Surg. 1995;121(5):577-82.

Sherman BE, Kendall K. A unique case of the rapid onset of a large cystic hygroma in the adult. Am J Otolaryngol. 2001;22(3):206-10.

Riechelmann H, Muehlfay G, Keck T, Mattfeldt T, Rettinger G. Total, subtotal, and partial surgical removal of cervicofacial lymphangiomas. Arch Otolaryngol Head Neck Surg. 1999;125(6):643-8.