Retroperitoneal cystic lymphangioma

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Abstract
Retroperitoneal cystic lymphangioma is a benign, endothelium-lined, cystic tumour of the lymphatic system. The tumour may be unilocular or composed of large cyst-like cavities filled with a clear, watery or serous fluid. It is more commonly seen in the neck, where it is called a cystic hygroma, and is relatively rare in the retroperitoneal area. It has been suggested that congenital or developmental misplacement and obliteration of draining lymphatics may lead to proximal cystic dilatation and the formation of these lymphangiomas; Some cysts may be due to other factors, such as trauma, resulting in lymphatic effusion and encapsulation, or to an acquired lymphatic obstruction. A 56-year-old man presented with a 10 cm deep, fixed abdominal mass in the left paramedian position below the level of the umbilicus. The mass was soft, cystic and painless on palpation. Echotomography showed a large, echo-free, smooth, cyst-like mass in the left paravertebral region (Fig. 1). This appearance was considered to be compatible with either a retroperitoneal cystic mass or a localized lymphoma. Subsequent lymphography showed an interruption of the left paraaortic lymphatic channels on the immediate post-injection fikns. The 24 h films showed a mass outlined by the lymphographic contrast medium which had presumably penetrated the cystic cavity and had become localized on the internal wall of the cyst (Fig. 2). These appearances suggested a large lymphatic cyst—the result of interruption of the para-aortic lymphatic channels.