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BMJ Case Reports 2018; doi:10.1136/bcr-2018-226319
  • Rare disease
  • CASE REPORT

Large mesenteric lymphangioma in an adult patient: an unusual presentation of a rare disease

  1. Dan G Blazer III2
  1. 1Duke University School of Medicine, Duke University Health System, Durham, North Carolina, USA
  2. 2Department of Surgery, Duke University Hospital, Durham, North Carolina, USA
  3. 3Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
  1. Correspondence to Dr Dan G Blazer III, trey.blazer{at}duke.edu
  • Accepted 12 September 2018
  • Published 7 October 2018

Summary

Lymphangiomas are most commonly described as a small painless mass in the neck or a vesicular rash in an infant patient. Ninety per cent of cases are diagnosed before the age of 2. Treatment usually involves surgical resection. Intra-abdominal lymphangiomas and mesenteric lymphangiomas, as described in our case report, represent a rare pathology. The exact prevalence of this condition is unclear but it has been suggested in the literature that there have been as few as 820 cases since the 16th century. The clinical presentation is usually subacute and diagnosis made incidentally during a workup of chronic gastrointestinal symptoms. Acute abdominal symptoms, as in our case presentation, are unusual but may be explained by the mass effect of a large intra-abdominal lesion. Cross-sectional imaging is key in preoperative workup and operative planning. Complete surgical resection is recommended and curative in the majority of cases with a low risk of local recurrence.

Footnotes

  • Contributors All authors contributed to the planning, writing and editing of this case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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