Cystic Hygroma with Multiple Benign Bone Lymphangiomas in an Adult Patient: A Rare Entity in the Differential Diagnosis of Multiple Osseous Lesions in Oncology Practice

Author(s): Ferit Aslan*, İnanç Güvenç, Aydın Aslan, Elif Günaydın

Journal Name: Current Medical Imaging
Formerly: Current Medical Imaging Reviews

Volume 17 , Issue 3 , 2021


Become EABM
Become Reviewer
Call for Editor

Graphical Abstract:


Abstract:

Cystic lymphangioma presenting with multiple bone lesions in an adult patient is a rare occurrence, with a limited number of reported cases in the literature. In this case report, we describe a 32-year old female patient with chronic neck and pelvic pain, and multiple lytic bone lesions on radiological imaging, which were eventually discovered to originate from cystic hygroma and widespread bone lymphangiomas that were present for more than 10 years. It should be kept in mind that there may be multiple benign causes of differential diagnosis in patients presenting with findings suggestive of diffuse bone metastasis. Misdiagnosis may cause the patient to receive unnecessary treatments, especially radiotherapy. In this case, we reached the diagnosis of benign disease, diffuse bone lymphangiomatosis. For this purpose, we also examine the long and stable medical history of the patient with the findings of BT, ultrasound, and bone scintigraphy.

We think that as long as there are no stable and serious results ofclinical and radiological findings of the patient, the patient should be approached with medical follow-up without treatment.

Keywords: Cystic hygroma, lymphangioma, bone lymphangioma, misdiagnosed bone metastasis, differential diagnosis bone metastasis, tumor.

[1]
Mirza B, Ijaz L, Saleem M, Sharif M, Sheikh A. Cystic hygroma: an overview. J Cutan Aesthet Surg 2010; 3(3): 139-44.
[http://dx.doi.org/10.4103/0974-2077.74488] [PMID: 21430825]
[2]
Principe DR, Rubin J, Raicu A, Hagen C. Massive adult cystic lymphangioma of the breast. J Surg Case Rep 2019; 2019(2)
[http://dx.doi.org/10.1093/jscr/rjz027] [PMID: 30792842]
[3]
Dhrif AS, El Euch D, Daghfous M, Cherif F, Mokni M, Dhahri AB. Archives de Pediatrie. Macrocystic lymphatic lymphangioma (cystic lymphangioma) of the upper extremity: a case report. Arch Pediatr 2008; 15(9): 1416-9.
[http://dx.doi.org/10.1016/j.arcped.2008.06.003] [PMID: 18667296]
[4]
Manar T, El-Essawy Hamdy H. Hassan:Cystic hygroma of the neck with multiple bone lymphangiomas. Egyp J Radiol and Nuc Med 2011; 42(2): 153-5.
[5]
Aviv RI, McHugh K, Hunt J. Angiomatosis of bone and soft tissue: a spectrum of disease from diffuse lymphangiomatosis to vanishing bone disease in young patients. Clin Radiol 2001; 56(3): 184-90.
[http://dx.doi.org/10.1053/crad.2000.0606] [PMID: 11247693]
[6]
Blei F. Lymphangiomatosis: clinical overview. Lymphat Res Biol 2011; 9(4): 185-90.
[http://dx.doi.org/10.1089/lrb.2011.0020] [PMID: 22196283]
[7]
Jin D, Sun X, Shen W, Zhao Q, Wang R. Diagnosis of lymphangiomatosis: A study based on CT lymphangiography. Acad Radiol 2020; 27(2): 219-26.
[http://dx.doi.org/10.1016/j.acra.2019.03.024] [PMID: 31076330]
[8]
Brown RR, Pathria MN, Ruggieri PM, Jacobson JA, Craig JG, Resnick D. Extensive intraosseous gas associated with lymphangiomatosis of bone: report of three cases. Radiology 1997; 205(1): 260-2.
[http://dx.doi.org/10.1148/radiology.205.1.9314995] [PMID: 9314995]
[9]
Wunderbaldinger P, Paya K, Partik B, et al. CT and MR imaging of generalized cystic lymphangiomatosis in pediatric patients. AJR Am J Roentgenol 2000; 174(3): 827-32.
[http://dx.doi.org/10.2214/ajr.174.3.1740827] [PMID: 10701634]
[10]
Rostom AY. Treatment of thoracic lymphangiomatosis. Arch Dis Child 2000; 83(2): 138-9.
[http://dx.doi.org/10.1136/adc.83.2.138] [PMID: 10906021]
[11]
Vittorio B, Vincenzo C, Giuseppe Danilo DS, Luigi M. Gamma emitters in pancreatic endocrine tumors imaging in the PET Era: Is there a clinical space for 99mTc-peptides? Curr Radiopharm 2019; 12: 156.
[http://dx.doi.org/10.2174/1874471012666190301122524]
[12]
Razmjooy N, Ashourian M, Karimifard M, et al. Computer-aided diagnosis of skin cancer: A review. Curr Med Imaging 2020; 16(7): 781-93.
[http://dx.doi.org/10.2174/1573405616666200129095242] [PMID: 32107997]
[13]
Marom EM, Moran CA, Munden RF. Generalized lymphangiomatosis. AJR Am J Roentgenol 2004; 182(4): 1068.
[http://dx.doi.org/10.2214/ajr.182.4.1821068] [PMID: 15039189]
[14]
Rajagopal A, McCormick J. Disseminated pulmonary lymphangiomatosis with bone involvement in an adult patient. Am J Respir Crit Care Med 2017; 195: A1531.
[15]
Yang DH, Goo HW. Generalized lymphangiomatosis: radiologic findings in three pediatric patients. Korean J Radiol 2006; 7(4): 287-91.
[http://dx.doi.org/10.3348/kjr.2006.7.4.287] [PMID: 17143033]
[16]
Estrela VV, Monteiro ACB, França RP, Iano Y, Khelassı A, Razmjooy N. Health 4.0: applications, management, technologies and review. Mèd Technologies J 2019; 2(4): 262-76.
[http://dx.doi.org/10.26415/2572-004X-vol2iss4p262-276]


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 17
ISSUE: 3
Year: 2021
Published on: 15 December, 2020
Page: [439 - 442]
Pages: 4
DOI: 10.2174/1573405616666201216100301
Price: $65

Article Metrics

PDF: 18
HTML: 1