A Case of a Retroperitoneal Cystic Lymphangioma Treated by Percutaneous Catheter Drainage and Sclerotherapy

Hyun Sik Kang; Seung Hyung Kim; Bong Soo Kim; Ki Soo Kang

doi:10.5223/kjpgn.2010.13.1.86

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Kang, Kim, Kim, and Kang: A Case of a Retroperitoneal Cystic Lymphangioma Treated by Percutaneous Catheter Drainage and Sclerotherapy

Case Report

Korean Journal of Pediatric Gastroenterology and Nutrition

Korean Journal of Pediatric Gastroenterology and Nutrition 2010; 13(1): 86-91.

Published online: 31 March 2010

DOI: https://doi.org/10.5223/kjpgn.2010.13.1.86

A Case of a Retroperitoneal Cystic Lymphangioma Treated by Percutaneous Catheter Drainage and Sclerotherapy

Hyun Sik Kang, M.D.^*, Seung Hyung Kim, M.D.^†, Bong Soo Kim, M.D.^†, Ki Soo Kang, M.D.^*,^‡

^*Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea.

^†Department of Radiology, Jeju National University School of Medicine, Jeju, Korea.

^‡Institute of Medical Science, Jeju National University, Jeju, Korea.

Responsible author (kskang@cheju.ac.kr)

Received 31 January 2010 Accepted 7 March 2010

Abstract

Retroperitoneal cystic lymphangiomas are benign, extremely rare tumors. Although surgical resection is the treatment of choice, sclerotherapy should be considered initially. A 9-year-old boy was admitted due do worsening abdominal pain of 4 days duration. Serial complete blood counts revealed a hemoglobin level of 12.8 g/dL on admission to 10.6 g/dL on hospital day 3. An abdominal computed tomography (CT) scan showed a large, lobulated, septated, retroperitoneal cystic mass (10×9.5×5 cm) in the left anterior pararenal space with intracystic hemorrhage surrounding the inferior mesenteric vein (IMV). Because of the high operative risk, we performed a tubogram of the cystic mass, percutaneous catheter drainage (PCD), and ethanol sclerotherapy. The follow-up abdominal CT scan showed that the cystic mass had decreased in size. He is well without relapse of the retroperitoneal cystic mass for 13 months after discharge. Sclerotherapy with PCD should be considered as initial therapy for patients with retroperitoneal cystic lymphangiomas at high surgical risk.

Keywords: Retroperitoneal cystic lymphangioma, Sclerotherapy

Figures and Tables

Fig. 1

On admission, an abdominal CT scan showed a large, lobulated, septated, retroperitoneal cystic mass (10×9.5×5 cm [arrowheads]) in the left anterior pararenal space with intracystic hemorrhage (^*) surrounding the inferior mesenteric vein (IMV [small arrow]).

Fig. 2

On hospital day 3, a T2-weighted MR scan showed the cystic mass had increased in size with hemorrhage. The hemoglobin level had changed to 10.5 g/dL.

Fig. 3

On hospital day 6, a tubogram was performed. The contrast media leaked out to the left paracolic gutters.

Fig. 4

On hospital day 15, a second tubogram showed no contrast leakage and the hemoglobin was 11 g/dL. Therefore, ethanol sclerotherapy was performed.

Fig. 5

Following abdominal CT showed the cystic mass (arrowhead) markedly decreased in size. The cystic mass still was surrounding inferior mesenteric vein (arrow).

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