Al-Ameer Ahmed Y, Alahmar Soha M, Shawafgfeh Nidal N, Miskeen Elhadi
Department of Surgery, College of Medicine, University of Bisha, Bisha, Saudi Arabia.
Department of Surgery, King Faisal Medical City of Southern Region, Abha-Aseer, Saudi Arabia.
Int Med Case Rep J. 2023 Jan 5;16:1-6. doi: 10.2147/IMCRJ.S387082. eCollection 2023.
Cystic hygroma (CH) in adults is a rare condition. Most CH cases are diagnosed at birth or during the first two years of life. Head and neck are the most common sites. There is scanty information about the natural history and follow-up of adult patients with axillary and breast CH. Hence, we present this case to shed some light on the natural history, complications, and a new suggested modality of treatment to deal with the complications.
We report a case of a 39-year-old female who presented after ten years of excision of the right axillary CH with massive breast edema and recurrence of cysts in the ipsilateral breast and axilla. The insertion treated the edema of a breast-peritoneal shunt.
The procedure was performed by inserting a normal V-P shunt catheter without a reservoir through a small incision in the inframammary fold toward the breast and another tiny incision at 10 of the clock in the right breast for fixation in the breast parenchyma. A catheter was inserted through a small incision on the right lumbar spine without intraperitoneal fixation after the catheter was inserted subcutaneously.
This case report shows that adult CH can reoccur. To our knowledge, this is the second case of CH concomitantly involving the breast and axilla. The shunt of the edematous fluid to the peritoneal cavity can give hope for intractable breast edema treatment.
成人囊状水瘤（CH）是一种罕见疾病。大多数CH病例在出生时或出生后的头两年被诊断出来。头颈部是最常见的发病部位。关于成人腋窝和乳腺CH患者的自然病史和随访的信息很少。因此，我们报告此病例，以阐明其自然病史、并发症以及一种新的针对并发症的建议治疗方式。
我们报告一例39岁女性，她在右腋窝CH切除术后十年出现了严重的乳腺水肿以及同侧乳腺和腋窝囊肿复发。采用乳腺 - 腹膜分流术治疗乳腺水肿。
该手术通过在乳房下皱襞处做一个小切口，将一根没有储液囊的普通脑室 - 腹腔分流导管插入乳房，并在右乳时钟10点位置做另一个小切口，以便将导管固定在乳腺实质内。在导管经皮下插入后，通过右腰椎处的一个小切口插入导管，导管未进行腹腔内固定。
本病例报告表明成人CH可复发。据我们所知，这是第二例CH同时累及乳腺和腋窝的病例。将水肿液分流至腹腔可为治疗难治性乳腺水肿带来希望。
