Solitary Cystic Mediastinal Lymphangioma: A Rare Incidental Case in an Adult Female.

INTRODUCTION

Lymphangiomas are rare, congenital malformations arising from lymphatic hyperplasia. More than 90% of cases are found in children under 2 years of age. Cystic lymphangiomas usually occur in the neck and axillary region and only rarely extend to the mediastinum.

CASE DESCRIPTION

We present the case of a middle-aged woman who presented with dyspnoea and productive cough. A chest x-ray showed right lower medial lung opacity, and a CT scan of the thorax showed a cystic mediastinal mass, encroaching on the superior vena cava and approaching the trachea and mainstem bronchus. An anterior thoracotomy with tumour resection was performed to relieve compression symptoms. The final pathology report confirmed the diagnosis of mediastinal lymphangioma.

DISCUSSION

Lymphangioma should be considered as one of the differential diagnoses when mediastinal widening is found on chest x-ray, and it should be investigated further with a CT scan and biopsy. Infiltration of surrounding structures can cause compression symptoms and can also make surgical resection more challenging.

LEARNING POINTS

Lymphangiomas are benign tumours of the paediatric population that can rarely occur in middle-aged adults as an acquired form.It is essential to investigate mediastinal enlargement seen on chest x-ray images even in the absence of any symptoms, as mediastinal lymphangiomas can grow to involve nearby anatomical structures.Although benign, lymphangiomas should be excised at the time of diagnosis to avoid anticipated complications and compression of anatomical structures causing respiratory difficulty, hoarseness and superior vena cava syndrome.Complete surgical resection is the mainstay of treatment and provides an excellent postoperative prognosis.