Giant cystic lymphangioma as a rare cause of acute abdomen in infancy: a case report and literature review

Abstract

Lymphangioma, a benign mass of lymphatic origin, primarily affects the head, neck, and oral cavity, with the abdomen being an uncommon location. Clinical presentation is defined by site of origin and size. We present the case of a 10-month-old male infant with no previous medical history, admitted to our department with diffuse abdominal pain and distension. Physical examination revealed a huge, palpable mass arising from the left abdomen, abdominal tenderness, guarding, and rigidity. Abdominal ultrasound revealed a multilocular, non-measurable mass with both cystic and solid components that were suggestive of a giant cystic lymphangioma. Multidetector computed tomography and magnetic resonance imaging were performed to estimate the size and extension of the tumor for preoperative planning. Moreover, an elevated alpha-fetoprotein level further supported the neoplastic origin of the tumor. Exploratory laparotomy was performed, and a mass measuring approximately 13.9×16.7×15.4 cm was identified and completely excised in negative margins. Histopathological findings confirmed the initial diagnosis. Our patient had an uncomplicated postoperative course and recovery, with no signs of recurrence on a 6-month follow-up. Giant abdominal lymphangiomas in infants are extremely rare and close attention for complications is vital. Surgical intervention with complete resection is considered the optimal management.