Isolated Mediastinal Lymphangioma: Prenatal Diagnosis and Thoracoscopic Treatment

Abstract

Isolated mediastinal lymphangiomas are uncommon. We report a case of a 14 × 8 mm right paracardiac cyst diagnosed at 20 weeks’ gestation. The prenatal evolution was uneventful and a magnetic resonance imaging at 31 weeks showed the limited extension of the cyst into the anterior mediastinum. At birth, the baby was asymptomatic, but the size of the lesion increased steadily (48 × 29 mm). At 7 months of life, he underwent a thoracoscopic resection of the cyst without intra or postoperative complications. Histological examination showed a lymphangioma. This case is remarkable for its prenatal diagnosis, the thoracoscopic treatment and the 8 years of followup without recurrence.

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F. Varlet, E. Guye, M. Varlet, T. Mireille, M. Guillaume and C. Gautier, "Isolated Mediastinal Lymphangioma: Prenatal Diagnosis and Thoracoscopic Treatment," Surgical Science, Vol. 1 No. 1, 2010, pp. 20-23. doi: 10.4236/ss.2010.11004.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] C. C. Wright, D. M. Cohen, R. K. Vegunta, J. T. Davis and D. R. King, “Intrathoracic Cystic Hygroma: A Report of Three Cases,” Journal of Pediatric Surgery, Vol. 31, No. 10, 1996, pp. 14301432.
[2] A. I. Philippart and D. L. Farmer, “Benign Mediastinal Cysts and Tumors,” In: J. A. O’Neill, M. I. Rowe, J. L. Grosfeld, E. W. Fonkalsrud and A. G. Coran, Eds. Pediatric Surgery, 5th Edition, St. Louis, 1998, pp. 839851.
[3] A. Lindinger, R. Boos, K. Pistorius, H. G. Limbach, H. J. Jesberger and W. Hoffmann, “Mediastinal Cystic Lymphangioma as a Cause of Hydrops Fetalis,” Klin Pediatr, Vol. 204, No. 2, 1992, pp. 118122.
[4] Y. Zalel, E. Shalev, M. BenAmi, G. Mogilner and E. Weiner, “Ultrasonic Diagnosis of Mediastinal Cystic Hygroma,” Prenatal Diagnosis, Vol. 12, No. 3, 1992, pp. 541544.
[5] J. K. Muraskas, J. G. Gianopoulos, A. Husain and P. R. Black, “Mediastinal Cystic Hygroma: Prenatal DecomPression with Neonatal Resection and Recurrence at 19 Months of Age,” Journal of Perinatology, Vol. 13, 1993, pp. 381384.
[6] M. P. Wu, R. C. Wu, J. S. Lee, W. J. Yao and P. L. Kuo, “Spontaneous Resolution of Fetal Mediastinal Cystic Hygroma,” International Journal of Gynecology & Obstetrics, Vol. 48, No. 3, 1995, pp. 295298.
[7] E. Jung, H. S. Won, P. R. Lee, I. S. Lee, A. Kim and J. H. Nam, “The Progression of Mediastinal Lymphangiomas in Utero,” Ultrasound in Obstetrics and Gynecology, Vol. 16, No. 7, 2000, pp. 663666.
[8] A. Bernasconi, S. J. Yoo, F. Golding, J. C. Langer and E. T. Jaeggi, “Etiology and Outcome of Prenatally Detected Paracardial Cystic Lesions: A Case Series and Review of the Literature,” Ultrasound in Obstetrics and Gynecology, Vol. 29, No. 4, 2007, pp. 388394.
[9] C. H. Comstock, W. Lee, R. A. Bronsteen, I. Vettraino and D. Wechter, “Fetal Mediastinal Lymphangiomas,” Journal of Ultrasound in Medicine, Vol. 27, No. 1, 2008, pp. 145148.
[10] R. Ruano, E. Takashi, R. Schultz and M. Zugaib, “Prenatal Diagnosis of Posterior Mediastinal Lymphangioma by Two and ThreeDimensional Ultrasonography,” Ultrasound in Obstetrics and Gynecology, Vol. 31, No. 6, 2008, pp. 697700.
[11] P. L. Giacalone, P. Boulot, P. Deschamps, et al., “Prenatal Diagnosis of a Multifocal Lymphangioma,” Prenatal Diagnosis, Vol. 13, No. 12, 1993, pp. 11331137.
[12] M. Hendrickson, K. Azarow, S. Ein, B. Shandling, P. Thorner and A. Daneman, “Congenital Thymic Cysts in Children—Mostly Misdiagnosed,” Journal of Pediatric Surgery, Vol. 33, No. 6, 1998, pp. 821825.
[13] J. L. Michel, Y. Revillon, P. Montupet, F. Sauvat, S. Sarnacki, N. Sayegh and C. NihoulFekete, “Thoracoscopic Treatment of Mediastinal Cysts in Children,” Journal of Pediatric Surgery, Vol. 33, No. 12, 1998, pp. 17451748.
[14] N. Borecky, F. Gudinchet, R. Laurini, B. Duvoisin, J. Hohlfeld and P. Schnyder, “Imaging of CervicoThoracic Lymphangiomas in Children,” Pediatric Radiology, Vol. 25, No. 2, 1995, pp. 127130.
[15] L. Ghedira, S. Haddad, K. Lajmi, et al., “Isolated Mediastinal Cystic Lymphangioma in Children: About Two Cases.” Respiratory Medicine CME, Vol. 1, No. 4, 2008, pp. 270273.
[16] A. M. Kavunkal, J. Ramkumar, S. Gangahanumaiah, K. N. Parimelazhagan and V. K. Cherian, (2007) “Isolated Mediastinal Cystic Lymphangioma in a Child,” The Journal of Thoracic and Cardiovascular Surgery, Vol. 134, No. 6, pp. pp. 15961597.
[17] D. K. Robie, M. H. Gursoy and W. J. Pokorny, “Mediastinal Tumors—Airway Obstruction and Management,” Seminars in Pediatric Surgery, Vol. 3, No. 4, 1994, pp. 259266.
[18] A. Adil and M. Ksiyer, “Unusual Mediastinal Cystic Lymphangioma. Report of a Case and Review of the Literature,” Interventional Radiology, Vol. 39, 1996, pp. 249252.
[19] L. E. Swischuk, J. C. Hoeffel and S. D. John, “Primary Intrathoracic Lymphangioma Masquerading as Teratoma,” Pediatric Radiology, Vol. 26, No. 11, 1996, pp. 827829.
[20] S. S. Rothenberg, “Thoracoscopy in Infants and Children: The State of the Art,” Journal of Pediatric Surgery, Vol. 40, No. 2, 2005, pp. 303306.
[21] G. Lemoine and P. Montupet, “Mediastinal Tumors in Infancy and Childhood. In Current Topics in General Thoracic Surgery,” Elsevier Science Publishing, 1991, pp. 258272.
[22] H. Takamatsu, H. Noguchi, H. Tahara, H. Kajiya and H. Akiyama, “Giant Mediastinal Lymphangioma in a Neonate: Report of a Case,” Surgery Today, Vol. 26, No. 7, 1996, pp. 527531.

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