外科ジャーナル

Diagnosis and Treatment of Mesenteric Cystic Lymphangioma: Case Report

Abstract

C�?�??�?�?lin Molnar, Vlad Lati�?�?��?Ÿ, Victor Iosif Neagoe, Doina Milutin, Vlad-Olimpiu Butiurca, Cosmin Nicolescu, Daniel Popa, Adrian Tudor and Constantin Copotoiu

Background: Mesenteric cysts, and particularly lymphangiomas, occur very rarely in adult patients. Due to this low incidence and their non-specific symptomatology, they often present a difficulty in diagnosis.

Case report: We present the case of a patient aged 58 years admitted to the Surgical Clinic 1, Târgu Mure�? Emergency County Hospital accusing diffuse abdominal pain and tenderness in the epigastrium. Abdominal ultrasound revealed a fluid cystic tumor, multi-septated, located in the root of the mesentery and the abdominal computer tomography confirmed this diagnosis. Surgery consisted of total cystectomy without compromising the intestinal segment and sparing the vascular structures in its vicinity. Cyst dimensions were approximately 70x50x30 mm and contained lymphatic fluid. The histopathological report confirmed a mesenteric cystic lymphangioma. The postoperative evolution was uneventful, with quick recovery and no postoperative complications.

Conclusions: The diagnosis of mesenteric cyst should be included in the differential diagnosis of intra-abdominal tumors in patients with nonspecific symptoms. Once this diagnosis is established histological differentiation between lymphangiomas and simple lymphatic cyst is essential. The total excision minimizes the recurrence rate, and their early removal can prevent complications caused by the compression and invasion of neighboring organs.