A unique case of rapid onset of a large cystic hygroma in the adult

Department of Otolaryngology--Head and Neck Surgery, School of Medicine, University of California Davis, Sacramento, CA 95817, USA.
American Journal of Otolaryngology (Impact Factor: 0.98). 05/2001; 22(3):206-10. DOI: 10.1053/ajot.2001.23430
Source: PubMed


Cystic hygroma is an uncommon lymphatic tumor seen rarely in adults, with less than 100 cases reported in the literature. The etiology and pathophysiology of this lesion is still in question. The majority of cystic hygromas occur in the head and neck, particularly in the posterior triangle. Although cystic hygromas tend to enlarge progressively over a span of weeks or months, relatively rapid enlargement over a span of days has been described. We present the unique case of an adult woman who experienced sudden onset of a large cystic hygroma in the neck without history of antecedent swelling, infection, or trauma. Successful surgical removal of the hygroma was performed. A brief review of the literature is presented.

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    • "Most are seen in the head and neck region (75–80%) and usually affect children under 2 years of age [1]. They are quite rare in adults [2]. The etiology of hygromas in adults is controversial, but they are thought to be due to proliferation of lymphoid vessels in response to head and neck trauma and/or infection [3]. "
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    ABSTRACT: Cystic hygromas/lymphangiomas are extremely rare malformations in adults. They are usually seen in infants and children under 2 years of age. En bloc resection is difficult due to the adhesive characteristics of the tumors. Inadequate surgical intervention often leads to recurrent disease. We report herein the case of a cystic hygroma/lymphangioma that presented as an uncommon mass on the cervical region in an adult, together with its histopathological, radiologic, and operative features.
    12/2014; 2014:209427. DOI:10.1155/2014/209427
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    • "Usually cystic hygromas are diagnosed clinically with large size, location and translucence. Although cystic hygromas tend to enlarge progressively over months a relatively rapid increase in size has also been described [8]. Cystic hygromas may be associated with Turner syndrome, Noonan syndrome, trisomies, fetal alcohol syndrome, chromosomal aneuploidy, cardiac anomalies and fetal hydrops [9]. "
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    ABSTRACT: Cervical cystic hygroma is a benign congenital malformation of the lymphatic system. Incidence of cystic hygroma is 1/6000 live births. We present a case of right neck mass with potential respiratory compromise in a newborn. The patient was a full term baby girl with an incidental finding of right neck mass which was described on ultrasound and magnetic resonance imaging as a cystic lesion in the nasopharynx and right neck which inferiorly followed the course of the right carotid artery, consistent with cystic hygroma. She started with respiratory compromise, and a follow-up magnetic resonance imaging showed increased size of the cystic hygroma. Dexamethasone was started to reduce fluid build up in the mass. When the cystic hygroma was found to be inseparable from the right half of the thyroid gland, the otolaryngologist performed hemithyroidectomy. The patient had neuropraxia involving the marginal mandibular branch of the facial nerve, which was expected to correct with time. Large cervical cystic hygromas may surround or displace neurovascular structures making their identification quite challenging intraoperatively. A team of experienced surgeons will help to ensure a successful surgical outcome.
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