Retroperitoneal lymphangioma

Case contributed by Tung Thai Nguyen
Diagnosis almost certain

Presentation

Vague left flank discomfort for 2 months. No history of other urinary symptoms. The laboratory results were within the normal range.

Patient Data

Age: 25 years
Gender: Female

Abdominal CT scan reveals a left-sided well-defined multilocular cystic mass in the retroperitoneal space. It has homogeneous density and no post-contrast enhancement. The cystic lesion extends from the undersurface of the left diaphragm to the left iliac region, displaces the stomach, descending colon, and pancreas anteriorly without evidence of invasion. The bowel loops are pushed towards the right side. The left renal pedicle is completely encased, with no vascular compromise. The left kidney has smooth contour and normal contrast enhancement. Renal excretory phase CT shows no pelvicalyceal dilatation.

Case Discussion

Retroperitoneal lymphangioma or retroperitoneal lymphatic malformation is a rare malformation that accounts for only 1% of all lymphangioma. Radiographic features are well-defined multilocular cystic masses with homogeneous fluid content. They can involve multiple compartments by crossing fascial planes.

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