Hygroma cysticum colli: a rare finding in advanced age

Introduction Lymphangiomas are benign neoplasms of the lymphatic vessels, which are mostly congenital and in 90 %  of cases diagnosed before the age of 2 years. Their occurrence in adulthood is extremely rare and is likely explained by an overload of a previously compensated local defect of the lymphatic vessels.

Methods : Case presentation, literature research

Case presentation : A 70-year-old female patient presented with a growing mass in the right supraclavicular region which had been noticed five months before. CT and MRI imaging revealed a cystic mass measuring 6 cm without infiltrative growth. Fine needle aspiration cytology (FNAC) revealed a suspected lymphocele. In the absence of malignancy indicators, the finding was addressed surgically a few days later and could be removed in toto. Histological and immunohistochemical evaluation confirmed the diagnosis of a macrocystic lymphangioma, also known as hygroma cysticum colli.

Discussion: The differential diagnosis of a unilateral cystic mass of the neck in adults generally includes a brachial cleft cyst, external laryngocele or a cystic lymph node metastasis. The FNAC is therefore essential for the exclusion of malignancy and the correct therapy planning. To minimize the risk of recurrence, a complete excision of the findings should be performed. Alternatively, sclerotherapy (via intralesional injection with picibanil, bleomycin, ethanol or doxycycline) can be used either primarily or as neoadjuvant therapy. A histological work-up of the intraoperative finding is obligatory even in the case of benign preoperative cytology.

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Publication History

Article published online:
13 May 2021