Thijs Ralf van Oudheusden, Simon Willem Nienhuijs, Thomas Bernard Joseph Demeyere, Michael Derek Philip Luyer, Ignace Hubertus Johannes Theodorus de Hingh, Department of Surgery, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands.
World J Gastrointest Surg. 2013 Oct 27;5(10):264-7. doi: 10.4240/wjgs.v5.i10.264.
Cystic lymphangiomas are rare benign tumors. Most frequently occurring in children and involving the neck or axilla, these tumors are much less common in adults and very rarely involve the abdomen. The known congenital and acquired (traumatic) etiologies result in failure of the lymphatic channels and consequent proliferation of lymphatic spaces. This case report describes a very rare case of a giant mesenteric cystic lymphangioma in an adult male with no clear etiology and successful resolution by standard radical resection. A previously healthy 44-year-old male presented with a 6-wk history of progressive upper abdominal pain, vomiting, anorexia and unintentional weight loss accompanied by rapid abdominal distension. A palpable mass was detected upon physical examination of the distended abdomen and abdominal computed tomography scan showed a giant multilobulated cystic process, measuring 40 cm in diameter. Exploratory laparotomy revealed an enormous cystic mass containing 6 L of serous fluid. The process appeared to originate from the lesser omentum and the lesser curvature of the stomach. Radical resection of the tumor was performed along with a partial gastrectomy to address potential invasion into the adjacent tissues. Histological analysis confirmed the diagnosis of a multicystic lymphangioma. The postoperative recovery was uneventful and the patient was discharged after 6 d. At 3-mo follow-up, the patient was in good health with no signs of recurrence.
囊性淋巴管瘤是一种罕见的良性肿瘤。大多数发生在儿童,累及颈部或腋窝,这些肿瘤在成年人中较少见,非常罕见累及腹部。已知的先天性和后天性(创伤性)病因导致淋巴管通道失败,继而导致淋巴管空间增殖。本病例报告描述了一例非常罕见的成人巨大肠系膜囊性淋巴管瘤病例,病因不明,经标准根治性切除后成功解决。一名 44 岁的既往健康男性,因 6 周的进行性上腹痛、呕吐、食欲不振和不明原因的体重减轻伴快速腹胀而就诊。腹部触诊时可触及膨胀腹部的可触及肿块,腹部计算机断层扫描显示巨大的多叶囊性病变,直径 40 厘米。剖腹探查显示出一个巨大的囊性肿块,其中含有 6 升浆液性液体。该过程似乎源自小网膜和胃的小弯侧。肿瘤进行了根治性切除,并进行部分胃切除术,以解决潜在的邻近组织侵犯问题。组织学分析证实了多房性淋巴管瘤的诊断。术后恢复顺利,患者在 6 天后出院。3 个月随访时,患者身体健康,无复发迹象。