Presentation
Right sided face and neck swelling
Patient Data
Large, multicystic, multiseptated lesion appearing T1 hypointense and T2/T2 TIRM hyperintense involving both the superficial and deep lobes of right parotid gland. There is no diffusion restriction of the lesion on DWI/ADC. No definite hemorrhagic or calcific foci on GRE. Post-contrast study shows few septal enhancement of the lesion.
The lesion is encasing the retromandibular vein in the parotid space. Anteriorly the lesion is extending towards masseter and buccal space. Medially, the lesion is compressing upon the right parapharyngeal space. Postero-medially, it is abutting the vessels of carotid space. Anteroinferiorly, it is extending towards submandibular space.
There is a small, subcentimetric area showing diffusion restriction within the parotid gland suggesting intraparotid lymph node. Overlying skin has normal thickness without any inflammatory changes. These all features are consistent with cystic lymphangioma.
Case Discussion
This was a biopsy proven cystic lymphangioma.
Cystic lymphangioma is a benign lesion with multiple lymphatic spaces. These are benign lymphatic malformations most commonly seen in children.
They occur most frequently in the head and neck region. Other less frequent sites observed are the axilla, shoulder, chest and abdominal wall.