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Cystic lymphangioma complicated by bleeding

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Left cervicothoracic mass since birth, suddenly increased in size the last 24 hours.

Patient Data

Age: 1 month
Gender: Male

The photo shows a large mass of the left lateral neck and upper anterior chest wall with no skin changes.

The ultrasound sections show a multiloculated and multiseptated cystic mass with posterior acoustic enhancement. The largest cyst (longitudinal section) shows a complex echogenicity with fine internal septations and echogenic fluid content (intracystic bleeding).

The CT scan confirms the multicystic nature of the mass, its deep location as well as its extension to the left occipital region, posterior cervical space and axillary region. It takes blood supply from the left subclavian artery. Note the largest cyst seen on ultrasound shows a thick and enhancing wall.

Case Discussion

The main complications of cystic hygroma / lymphangioma are internal bleeding and infection. 

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