Laparoscopic resection of a giant mesenteric cystic lymphangioma
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62 Hellenic Journal of Surgery 2013; 85: 1
Laparoscopic Resection of a Giant Mesenteric Cystic Lymphangioma Case Report C. Simoglou, L. Simoglou, D. Babalis Received 03/10/2012 Accepted 01/11/2012
Abstract Aim-Background: We report the case of a patient with a large mesenteric cyst lymphangioma containing roughly 700ml of fluid that we satisfactorily resected laparoscopically in our small Hospital. Lymphangioma is considered to be a hamartoma. It is an uncommon finding in adults, with a reported incidence of 1/100.000 of necropsy studies, and 1/105.000 of patients admitted. Case Report: A 42-year-old woman displayed a large (14X11X8 cm) mesenteric cystic mass in the left anterior pararenal region that crossed the midline; the tumour head was in contact with the tail of the pancreas. This finding suggested a cystic lymphangioma. Conclusion: Laparoscopic removal of the cyst has certain advantages over classical laparotomy; specifically, it is less painful and avoids postoperative ileus, the stay in the hospital is shorter and the patient returns to normal activities sooner. Cystic lymphangioma is a rare benign vascular tumour that may arise in various sites, and be found at any age.
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mesenteric cystic mass in the left anterior pararenal region that crossed the midline; the tumour head was in contact with the tail of the pancreas. This finding suggested a cystic lymphangioma (Fig. 1). With the patient under general anaesthesia, we created a pneumoperitoneum with a Verres needle introduced through a supraumbilical incision. The Verres needle was then replaced by a 10mm trocar through which we introduced an Olympus 30 optic. Guided by the laparoscope, we introduced four more 10mm trocars. We then perforated the cyst with a Verres needle and emptied it. Subsequently, we resected the entire wall of the cyst and dissected it free from the mesenteric vessels; there was no need to ligate any branches. The wall of the cyst was extracted through one of the trocars [2]. Histopathological examination showed a fibroelastic capsule lined by endothelial cells, confirming the diagnosis of mesenteric cystic lymphangioma. The patient made an uncomplicated recovery and was discharged on the second postoperative day. Twelve months later, she is healthy with no signs of relapse.
Cystic Lymphangioma, Surgical Treatment, Tumour, Diagnosis, Mesenteric Cystic
Case Presentation Written informed consent has been obtained from the patient, for the publication of her personal data. A 42-year-old woman presented with hypogastric pain and abdominal distension, and a history of cancer of the uterine neck 10 years earlier. The neoplasm was diagnosed by cytological screening and classified as Papanicolaou grade IV. She underwent a total hysterectomy and histological examination confirmed cancer in situ of the uterine neck [1]. Abdominal echography and subsequent computed tomography (CT) showed a large (14X11X8 cm) Fig.1 Computed tomogram of the abdomen. The head of the cystic mass is in close contact with the tail of the pancreas in t
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