Cystic hygroma : About 25 cases
Keywords:
Cystic hygroma- Surgery- SclerotherapyAbstract
Background: The cystic hygroma is a benign lymphatic malformation, a rare but potentially serious in its character and its evolutionary trend dissecans. The head and neck region constitutes the favorite seat (75%). If the diagnosis is usually easy, the therapeutic management remains controversial.
Aim: To analyze clinical and paraclinical characteristics of cystic hygroma and to discuss the various therapeutic methods.
Methods: We report a retrospective study about 25 cases of head and neck cystic hygroma collected during a period of 11 years (1998- 2008) in the ENT department of the hospital The Rabta Tunis.
Results: The average age of our patients was 18 years and 5 months. All patients consulted for a neck mass. It was localized in the submandibular region in 7 cases, 3 cases in parotid region, jugulocarotid artery in 3 cases and affecting the posterior triangle in 12 cases. Cervical ultrasound was performed in 22 cases (88%) evoking the diagnosis of cystic hygroma in 16 cases (72%). CT was performed in 10 cases finding hypodense aspect in 8 cases. MRI was carried out in 9 cases. It showed the aspect hyperintense T2, hypointense T1 in 7 cases. Surgical excision was performed in 22 cases and sclerotherapy in 3 patients. During the evolution, a recurrence was observed for each treatment modality.
Conclusion: Surgery is treatment of choice of cystic hygroma. Sclerotherapy may be indicated as an alternative to surgery in localized and diffuse macrocystic forms.
Downloads
References
Rakotosamimanana J, Raharisolo Vololonantenaina CR, Ratovoson H, Ahmad A, Razafindramboa H. Lymphangiome kystique cervico-médiastinal : à propos d'un cas et revue de la littérature Arch Inst Pasteur Madagascar 2000; 66:61-4.
Al-Khateeb TH, Al Zoubi F. Congenital Neck Masses: A Descriptive Retrospective Study of 252 Cases. J Oral Maxillofac Surg 2007; 65:2242-7.
Arthur J T, Lawrence W C T, Arthur J R et al. Pediatric neck masses: guidelines for evaluation. Int J Pediatr Otorhinolaryngol 1988; 16:199-210.
Claus W, Olaf M, Michael S et al Lymphatic malformations of the head and neck: Introduction of a disease score for children,Cologne Disease Score (CDS). Int J Pediatr Otorhinolaryngol 2006; 70:1205-12.
Zhi-Min L, Xing-Xing H, Zhi-Jun S, Wen-Feng Z, Yi-Fang Z. Surgery of lymphatic malformations in oral and cervicofacial regions in children Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104:338-44.
Brock ME, Smith RJ H, Parey SE, Mobley DL. Lymphangioma. An otolaryngologic perspective. Int J Pediatr Otorhinolaryngol 1987; 14:133-40.
Wei-liang C, Bing Z, Jian-guang W, Hua-shan Y, Da-ming Z, Zhi_quan H. Surgical excision of cervicofacial giant macrocystic lymphatic malformations in infants and children. Int J Pediatr Otorhinolaryngol 2009; 73:833-7.
Nicollas R, Roman S, Triglia JM. Chirurgie des malformations congénitales du cou chez l'enfant. Encycl Med Chir 46- 480.2006.12p
Best SR, Coelho DH, Ahrens WA, Atez G, Sasaki CT. Laser excision of multiple esophageal lymphangiomas: A case report and review of the literature. Auris Nasus Larynx 2008; 35:300-3.
François M, Guillou C, Depondt J, Aboucya JP,Contencin Ph, Narcy Ph. Les lymphangiomes cervico-faciaux chez l'enfant. Ann Otolaryng 1986; 103:113-7
Nancy MB, Chantal MG, Jose MM, Yutaka S, Diane KB, Richard JHS. Management of lymphatic malformations: if, when, and how. Head Neck Surg 2002; 13:85-92.
Wierzbicka E, Herbreteau D, Robert M, Lorette G. Malformations lymphatiques kystiques. Ann Dermatol Venereol 2006; 133:597-601.
Wong KT, Lee YYP, King AD, Ahuja AT. Imaging of cystic or cyst-like neck masses. Clin Radiol 2008; 63:613-22.
Isenberg SF. Cystic Hygroma: Recurrence in an adult 34 years later. Am J Otolaryngol 1995; 16:347-9.
Grabb WC, Dingman RO, Oneal RM, Dempsey PD. Facial hamartomas in children: neurofibroma, lymphangioma and hemangioma. Plast Reconstr Surg 1980; 66:509-27.
Touhami M, Moumen M. Les lymphangiomes kystiques cervicofaciaux. JChir 1991; 128:145-52.
Hancock BJ, Dickens SV, Luks FI, Di Lorenzo M, Blanchard H. Complications of Lymphangiomas in Children J Pediatr Surg 1992; 27:220-6.
Alqahtani A, Nguyen LT, Flageole H, Shaw K, Laberge JM. 25 years'experience with lymphangiomas in children. J Pediatr Surg 1999; 34:1164-8.
Riechelmann H, Muehlfay G, Keck T, Mattfeldt T, Rettinger G. Total, Subtotal, and Partial Surgical Removal of Cervicofacial Lymphangiomas. Arch Otolaryngol Head Neck Surg1999; 125:643-8.
Martinot V, Descamps S, Février P et al. Évaluation du traitement des lymphangiomes kystiques par injection percutanée d'Éthibloc® chez 20 patients. Arch Pediatr 1997; 4 :8-14.
Acevedo JL, Shah RK, Brietzke SE. Nonsurgical therapies for lymphangiomas:A systematic review. Otolaryngol Head Neck Surg 2008 ; 138:418-24.
Sichel JY, Udassin R, Gozal D, Koplewitz BZ, Dano I, Eliashar R. OK-432 therapy for cervical lymphangioma. Laryngoscope 2004; 114:1805-9.
Mathur NN, Rana I, Bothra R, Dhawan R, Kathuria G, Pradhan T. Bleomycin sclerotherapy in congenital lymphatic and vascular malformations of head and neck. Int J Pediatr Otorhinolaryngol 2005; 69:75-80.
