[Cystic lymphangioma of the mesentery. Clinical, radiological, and morphological analysis].

BACKGROUND

The cystic mesenteric lymphangioma is a rare benign neoplasia, that can be misdiagnosed with others cystic intra-abdominal tumors.

OBJECTIVE

To shown the clinical and histopathological features of a cystic mesenteric lymphangioma.

METHODS

A 17-year old male with a past history of 17 days of right lower abdominal pain, palpable mass, fever, nausea and vomitus. The initial clinical diagnosis was appendicitis, during the appendectomy a mesenteric tumor was found. The patient was then sent to a third level cancer center for further diagnosis and treatment. In an abdominal CT scan a multicystic retroperitoneal tumor was found and diagnosed as a cystic pancreatic tumor. At midline exploratory celiotomy a cystic tumor infiltrating the right colon mesenterium, duodenum, proximal jejunum, and pancreas head was found. A pancreatoduodenectomy in bloc with right hemicolectomy was performed. During the postoperative period the patient developed cholestasis due to endovenous parenteral nutritional support that improved when it was suspended. The patient was discharged without complications at the 15th postoperative day. The histopathologic diagnosis was cystic mesenteric lymphangioma. At 12 months of follow-up the patient is healthy.

CONCLUSIONS

The cystic mesenteric lymphangioma is a rare benign tumor and its diagnosis should be included in the differential diagnosis of cystic intra-abdominal neoplasias. Due to the tumor's location, as in the current patient, the surgeon should plan the appropriate surgery as to avoid morbidity, since the objective of such treatment is curative.