Surgical Management of Cervico-facial Cystic Lymphangioma in Children

Introduction: Cystic lymphangioma or cystic hygroma is a congenital malformation of the lymphatic system that manifests as a soft, benign, and painless mass. It originates from remnants of embryonic lymphatic tissue that retains the potential for proliferation. Material and methods: Our retrospective study involved 16 cases of cystic lymphangioma managed between 2017 and 2020. Results: This study included 9 girls and 7 boys with a mean age of 4.2 years. Cystic lymphangioma was visible in 7 cases at birth and in 6 cases before the age of 2 years, and beyond 2 years in 3 cases. The tumor was cervical in 11 cases, including one case of parotid extension, and 02 cases of sub maxillary extension, jugal in one and one case of parotid localization, and one case of lingual localization. Surgical indication was based on clinical examination and imaging in all cases. Excision was considered complete in 12 cases and incomplete in four cases. In three cases, excision was difficult due to adhesion to the internal jugular vein and the carotid bifurcation, base of the tongue in one case and facial nerve in one case. Early complications were, hematoma [one case], lymphorrhea [one case], jugal recurrence [one case] nine months after surgical excision. Conclusion: Cervico-facial cystic lymphangioma is a particular pathology whose management is challenging, complex and multidisciplinary.