Giant cystic lymphangioma in childhood: a rare differential for the acute abdomen

Abstract

Cystic lymphangiomata are rare benign tumours of childhood resulting from an abnormal development of the lymphatic system, most commonly arising in the head and axillary region. We report a case of haemorrhagic intra-abdominal cystic lymphangiomata presenting as an acute abdomen. A 5-year-old girl was admitted with low-grade fever, generalised abdominal pain and elevated inflammatory markers, and a clinical diagnosis of acute appendicitis was made. At operation, two large fluid-filled haemorrhagic cystic lesions were found to occupy most of the abdominal cavity. The lesions were completely excised and histological examination identified them as cystic lymphangiomata. This case report and literature review highlights aspects of the presentation which might have resulted in a preoperative diagnosis, which is seldom achieved.