A rare case of huge intra-abdominal cystic lymphangioma arising from rectovesical pouch; a case report

INTRODUCTION AND IMPORTANCE: Lymphangiomas are benign maldevelopment of the lymphatic vessels; they classically occur in the head and neck region. They are usually seen in newborn and pediatric age groups, especially below two years of age, and rarely occur in adults. PRESENTATION OF CASE: A 27-year-old male patient presented with progressive abdominal swelling of two-year duration. He had also difficulty breathing from the mass effect of a huge intra-abdominal mass. He was emaciated; vital signs were in the normal range, except for tachypnea. His abdomen was hugely distended, tense, dull to percussion, and the umbilicus was everted. CT scan revealed a multiseptated cystic mass. He underwent complete surgical excision with ligation of the cyst peduncle. The diagnosis of cystic lymphangioma was confirmed after a histopathologic examination. CLINICAL DISCUSSION: Lymphangiomas have an incidence rate of one in every 20,000 to 250,000 populations. The clinical presentation of abdominal cystic lymphangioma is non-specific and is related to the size, and location of the tumor. The preoperative diagnosis of abdominal cystic lymphangioma is often challenging and leads to misdiagnosis. The management of abdominal cystic lymphangioma depends on the mode of presentation and location of the tumor. It has good prognosis after complete surgical resection of the tumor. CONCLUSION: Abdominal cystic lymphangioma arising from the rectovesical pouch is a very rare condition. The best management is complete surgical resection to prevent a recurrence. Despite, the rarity of the disease in adults they should be considered as a differential diagnosis in cystic abdominal tumors.