Laparoscopic resection of a huge retroperitoneal cystic lymphangioma after successful reduction of tumor size with a double balloon catheter

INTRODUCTION: Retroperitoneal cystic lymphangiomas are rare. We report a case of retroperitoneal huge cystic lymphangioma that was successfully aspirated the cyst’s contents with double balloon catheter and excised laparoscopically. PRESENTATION OF CASE: A 34-year-old man was admitted to our hospital with low-grade fever and abdominal pain that had lasted for 1 week. Abdominal computed tomography and magnetic resonance imaging showed a fluid-filled multilocular mass measuring 13.5 cm in diameter around the tail of the pancreas, which was diagnosed as a retroperitoneal cystic lymphangioma. We successfully excised the tumor by laparoscopic distal pancreatosplenectomy. We punctured and aspirated the tumor with a double-balloon catheter to decrease the tumor’s size without spilling the tumor content. Cytology showed no malignant cells, and histopathological examination confirmed cystic lymphangioma. No recurrence was noted on radiographic imaging 10 months postoperatively. DISCUSSION AND CONCLUSION: Laparoscopic treatment for retroperitoneal huge cystic lymphangioma is feasible, and the double balloon catheter is useful for reducing the tumor volume.