Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, Japan.
Department of Surgery, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae, Tokyo, Japan.
Clin J Gastroenterol. 2021 Dec;14(6):1791-1797. doi: 10.1007/s12328-021-01492-6. Epub 2021 Aug 12.
Lymphangiomas are classified as lymphatic malformations, which are more common in children and rare in adults. It frequently occurs in the cervical and axillary regions and uncommonly in the retroperitoneum. A 39-year-old woman presented to our department for the investigation for a 55 mm asymptomatic mass in the right anterior adrenal cavity. Abdominal ultrasound showed a tumor containing cysts in the right anterior adrenal cavity. Contrast-enhanced computed tomography showed that the tumor was poorly contrasted and ill-defined. Magnetic resonance imaging suggested that the tumor contained a small amount of fat. The tumor tended to grow, and the possibility of malignant diseases such as liposarcoma could not be excluded. Therefore, surgical resection was performed. Since intraoperative findings showed that the tumor tightly invaded to the duodenum and pancreatic head, a pancreaticoduodenectomy was selected. The entire tumor was removed without exposing the tumor. Macroscopic findings indicated that the specimen was 55 mm in size, indistinctly demarcated, yellow-white in color, and polycystic. Histologically, lymphovascular proliferation was observed with infiltration of the pancreatic head and the duodenal muscle layer. The diagnosis of lymphangioma was finally made. There was no recurrence 2 years after surgery.
淋巴管瘤被归类为淋巴管畸形，它在儿童中更为常见，在成人中则较为罕见。它常发生于颈部和腋窝，而在后腹膜腔中则较少见。一位 39 岁的女性因右肾上腺前腔 55mm 无症状肿块到我科就诊。腹部超声显示右肾上腺前腔有一个包含囊肿的肿瘤。增强 CT 显示肿瘤对比度差，边界不清。磁共振成像提示肿瘤含有少量脂肪。肿瘤有生长趋势，不能排除脂肪肉瘤等恶性疾病的可能性。因此，进行了手术切除。由于术中发现肿瘤紧密侵犯十二指肠和胰头，选择进行胰十二指肠切除术。整个肿瘤被切除，未暴露肿瘤。大体观察结果显示标本大小为 55mm，界限不清，呈黄白色，多囊性。组织学上观察到淋巴血管增生，伴有胰头部和十二指肠肌层浸润。最终诊断为淋巴管瘤。术后 2 年无复发。
