EC Clinical and Medical Case Reports

Mediastinal cystic lymphangiomas are extremely uncommon vascular tumors that develop from the lymphatic vessels. Most patients are asymptomatic. Symptoms may include cervical swelling, dysphagia, dyspnea, chest pain, or cough. Here, we describe a case of mediastinal cystic lymphangiomas in a 19-year-old female patient, complaining of a soft, fluctuating right basi-cervical mass. The diagnosis is based on clinical signs and imaging (CT and MRI), which showed two mediastinal multilocular cystic masses and a percutaneous fine-needle biopsy verified the diagnosis of cystic lymphangioma. Surgical excision is curative, but our patient refused to undergo surgery since there was no significant impact on her quality of life.

 Keywords: Mediastinum; Lymphangioma; MRI; CT

1. Teruya Komatsu and Yutaka Takahashi. “Mediastinal cystic lymphangioma in a patient with situs inversus totalis”. Case Reports in Surgery (2014): 781874.
2. Dionísio AC., et al. “Giant cystic mediastial lymphangioma”. EJCRIM1 (2019): 001323.
3. Valeria Romeo., et al. “A case of lower-neck cystic lymphangioma: correlative US, CT and MR imaging findings”. Quantitative Imaging in Medicine and Surgery 4 (2013): 224-227.
4. Fateme Salehi., et al. “Case report of a rare cystic mediastinal lymphangioma mimicking recurrent pleural effusion”. Case Reports in Radiology (2019): 1301845.
5. F Maldonado., et al. “Pleural fluid characteristics of chylothorax”. Mayo Clinic Proceedings2 (2009): 129-133.
6. Sook Hee Chung., et al. “Asymptomatic lymphangioma involving the spleen and retroperitoneum in adults”. World Journal of Gastroenterology 44 (2009): 5620-5623.
7. N Khobta., et al. “Solitary cystic mediastinal lymphangioma”. European Respiratory Review127 (2013): 91-93.
8. Suat Eren and Zeki Bakir. “Imaging features of cervical lymphangiomas as a cause of respiratory distress and vascular-lymphatic disturbance”. Eurasian Journal of Medicine1 (2009): 39-43.
9. L Ghedira., et al. “Isolated mediastinal cystic lymphangioma in children: About two cases”. Respiratory Medicine CME 1 (2008): 270-273.
10. B Bender., et al. “The changing management of chylothorax in the modern era”. European Journal of Cardio-Thoracic Surgery 1 (2015): 18-24.
11. Handa R., et al. “Isolated mediastinal lymphangioma herniating through the intercostal space”. Asian Journal of Surgery 3 (2004): 241-242.
12. Mohammed Hussein Abdi., et al. “Unusual presentation of a mediastinal cystic hygroma”. Case EURORAD (2021): 17492.
13. Tai P T H and Jewell L D. “Case Report: Mesenteric mixed haemangioma and lymphangioma; report of case with 10-year follow-up after radiation treatment”. The British Journal of Radiology810 (1995): 657-661.