Cystic lymphangioma is a rare tumour, frequently situated in the cervical or axillary region and exceptionally intraabdominal. It is essentially a malformation of one of the abdominal lymph vessels where a portion is dilated and form a lymph fluid-filled cyst. Abdominal lymphangiomas are more common in boys and usually occur in childhood. It arises due to a congenital defect in the connection of the primary lymphatic channels with the central collecting system. It presents clinically either in the form of a pseudo-appendix or pseudo-ascites syndrome or in the form of an abdominal tumour with or without compression of adjacent structures. The clinical symptoms are variable. Chronic symptoms include chronic abdominal pain and progressive abdominal distension.



Cysts are thought to originate from lymphatic spaces associated with the immature retroperitoneal lymph sac, making them similar to cystic hygromas, which originate in the neck in association with the jugular lymph sac. Another proposed etiology is lymphatic interference. The tumor is a hamartoma or vascular developmental anomaly arising from lymphatic vessels, manifesting as a raised, tender, bushy, bubbly, pinkish-white lesion; esthetic considerations may justify attempted removal of lymphangiomas. Mesenteric and omental cysts can be easy or dual, unilocular or multilocular, and they may carry hemorrhagic, serous, chylous, or contaminated fluid. The fluid is serous in ileal and colonic cysts and is chylous in jejunal cysts.

Acute symptoms normally include intense abdominal pain and distension, vomiting, fever and peritonitis. Although an abdominal lymphangioma is considered harmless, it may get locally intrusive. Therefore any involved organ must too be resected. Incomplete resection may head to recurrence. If the patient was treated with marsupialization, closer follow-up for potential recurrence should be instituted. Otherwise, no long-term follow-up for postoperative problems is needed. Intraabdominal lymphangiomas are harmless lesions but considering their local intrusive holding comprehensive resection of the cyst along with involved organ and clinical and radiological come upward for recurrence is needed.

The prognosis of lymphangiomas depends on the position and extent of the lesion and the presence of new associated abnormalities. Genetic syndromes that are associated with cystic hygroma include Turner syndrome and some trisomies e. g. trisomy 13, 18 and 21. Complete resection is the treatment of choice and has an excellent prognosis. Although an abdominal lymphangioma is considered benign, it may become locally invasive. Although an abdominal lymphangioma is considered benign, it may become locally invasive. Therefore any involved organ must also be resected. Incomplete resection may lead to recurrence. Treatment is well defined and consists of surgical resection of the isolated lymphangioma or associated with the adjacent intestine, depending on the site of the tumour. It has a good prognosis.