A Case of Prenatally Diagnosed Fetal Retroperitoneal Cystic Lymphangioma / 대한산부인과학회잡지

Lymphangiomas are congenital malformations of lymphatic vessels that have the potential to infiltrate surrounding structures. In 95% of cases, they are located in the neck (cystic hygroma), head and axilla. But they can occur in a variety of anatomical locations, such as the abdominal cavity, extremities and urinary bladder. Pathologically they can be classified into three group: lymphangioma simplex; carvenous lymphangioma; and cystic lymphangiomas or hygromas. Mixed lesions may coexist in different areas of the same lymphangioma. Although these lesions are benign, they have a propensity for rapid growth and invasion into the underlying muscles and connective tissues. A extensive mass can compress adjacent vital organs, which determines the severity of the lesion. Accurate prenatal diagnosis and anatomical evaluation are important as they permit planned delivery and prompt postnatal resuscitation, and allow the option of terminating the pregnancy if a poor outcome is predicted. Prenatal MRI can confirm ultrasonographic findings, provide detailed fetal anatomical evaluation, and demonstrate the extent and character of lymphangiomas. We present a case of a huge retroperitoneal cystic lymphangioma diagnosed prenatally using ultrasound and MRI at 26 weeks gestation.

Fetal Axillary Cystic Hygroma Detected by Prenatal Ultrasonography: A Case Report

Fetal cystic hygroma is a rare developmental congenital anomaly of the lymphatic system, characterized by the formation of a multilocular, variable sized cystic mass. Most of cystic hygromas are found in the neck and other rare locations include axilla, mediastinum, and limbs. There are many papers about cystic hygroma colli, but there are only a few papers about fetal axillary cystic hygroma and no domestic papers. We present a case of fetal axillary cystic hygroma diagnosed antenatally followed by full-term delivery in a 30-yr-old woman. Operation was performed on the 8th day after birth and the mass was excised and confirmed as cystic hygroma.

Two Cases of Fetal Giant Lymphangiomas / 대한산부인과학회잡지

In this paper, two unusual cases of fetal giant lymphangiomas diagnosed before delivery is reported in 18 and 26-week pregnant woman. They were diagnosed by ultrasound. Although the cause of lymphangioma is not clearly established, they probably arise from a failure of the developing lymphatic tissue to establish normal connection with the draining lymphatics. These anomalies are most often cervical (about 70~80%) but occasionally present in the axilla (about 10%), thorax and abdomen. Lymphangioma arising at posterior nuchal region is called cystic hygroma. Lymphangioma may be divided histologically into three types ; simple, cavernous or cystic. Ultrasound examination is essential method in prenatal diagnosis of fetal lymphangioma. The differential diagnosis of these fetal lymphangioma should include meningomyelocele, benign cystic teratoma, nuchal edema, encephalocele, and subchorial placenta cyst. About 60 to 70% of lymphangioma is accompanied with chromosomal abnormalities, and most common type is Turner's symdrome (40~80%), but occasionally trisomy 21, 18, 13 and 47 XXY. But chromosomal studies of these cases showed normal findings. The 26-week fetus was IUFD at 29 gestational weeks and terminated by hysterotomy. Other 18-week fetus was terminated by vaginal delivery after intrauterine decompression.