A retroperitoneal cystic lymphangioma involving the spleen and pancreas: a case report

Retroperitoneal cystic lymphangioma (CL) is a rare condition and accounts for 1% of all CL. It can be congenital in children associated with genetic disorders or acquired in adults with chronic diseases. CASE PRESENTATION: In the present case, the girl complained of abdominal pain and dysuria. Clinical examinations showed a palpitated mass in her left pelvis; a radiology exam revealed a cystic mass infiltrating the spleen and pancreatic tail, reaching the pelvis. The mass, including the spleen and pancreatic tail, among the cystic compound was removed. The final diagnosis of benign CL was done based on a histopathology exam. A one-year follow-up showed no signs of recurrence. CLINICAL DISCUSSION: CL is usually asymptomatic. The retroperitoneal location of the mass delayed the diagnosis and allowed the mass to grow to a large size and compress nearby structures. The typical presentation of CL is usually a substantial, multichambers cystic mass. However, it could be easily misdiagnosed with other cystic tumors of the pancreas. Age-based differential diagnosis should be taken into consideration in children as abdominal mass can originate from gastrointestinal or genitourinary systems. CONCLUSION: The imaging features of CL are insufficient, and the final diagnosis depends on the histopathology exam. Furthermore, CL can mimic pancreatic cysts in its presentation and cite; therefore, it must be included in the diagnosing strategy whenever a retroperitoneal cyst is being investigated, as imaging features can be misleading. Surgical treatment of CL should be associated with long-term ultrasound follow-up to identify and manage recurrence early.