Unraveling of Radiological and Therapeutic Approach to Cervical Cystic Lymphangioma in Elderly Patient: A Rare Case Report

Fiona Fiona; Ency Eveline; I Made Dwijaputra Ayusta; Putu Patriawan; Ni Made Mahastuti

Authors

Fiona Fiona Department of Radiology, Faculty of Medicine Udayana University, Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia https://orcid.org/0000-0002-8553-2262 (unauthenticated)
Ency Eveline Department of Radiology, Faculty of Medicine Udayana University, Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia
I Made Dwijaputra Ayusta Department of Radiology, Faculty of Medicine Udayana University, Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia
Putu Patriawan Department of Radiology, Faculty of Medicine Udayana University, Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia
Ni Made Mahastuti Department of Pathological Anatomy, Faculty of Medicine Udayana University, Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia

Keywords:

Lymphangioma, cervical, cystic, elderly, radiology

Abstract

Background: Cervical cystic lymphangioma is rarely reported in elderly patients. This case report aimed to establish a diagnosis and determine the proper treatment by considering the probability of cervical cystic lymphangioma in the elderly based on radiological examination.

Objective: To report an uncommon case of lymphatic malformation in the neck region was reported in an elderly woman.

Case Report: A 58-year-old woman presented with a right neck mass that had progressively enlarged over the year. Ultrasound (US) and contrast-enhanced computed tomography (CECT) scans of the neck revealed clustered cystic lesions in the right submandibular, upper anterior and posterior jugular, mid and lower jugular, upper and lower posterior triangle, and medial and lateral supraclavicular regions, consistent with cervical cystic lymphangioma. Fine-Needle Aspiration Biopsy (FNAB) revealed an acellular cystic lesion, which was later confirmed to be a lymphangioma. The tumor was reduced with sclerotherapy and bleomycin injection.

Conclusion: Lymphangioma is a rare benign lession characterized by fluid-filled masses of lymphatic tissue that typically occur in the head and neck region. Although it can be congenital in origin, these lesions usually present in children under the age of two. Adult lymphangioma is a rare condition, with fewer than 80 documented cases in the literature. Cervical cystic lymphangioma can be diagnosed with US and CECT examinations, as well as histological examinations. The preferred treatment is sclerotherapy and surgical resection.