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Case report
Spontaneous partial regression of a microcystic jejunal mesenteric lymphangioma and a proposed management algorithm
  1. Dominic Ti Ming Tan1,2,
  2. Aik Yong Chok3,
  3. Benjamin Livingston Farah4,
  4. Yet Yen Yan5 and
  5. Ee-Lin Toh3
  1. 1 College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
  2. 2 Department of Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
  3. 3 Department of Colorectal Surgery, Singapore General Hospital, Bukit Merah, Singapore
  4. 4 Division of Pathology, Department of Anatomical Pathology, Singapore General Hospital, Bukit Merah, Singapore
  5. 5 Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore
  1. Correspondence to Dominic Ti Ming Tan; dominic.tan.ti.ming{at}gmail.com

Abstract

Mesenteric lymphangiomas are relatively rare, with clinical symptoms ranging from an asymptomatic presentation to an acute abdomen. The natural history and biological behaviour of this entity can range from slow indolent lesions to aggressive tumours with a risk of malignant transformation. Spontaneous regression of a mesenteric lymphangioma is rare. We herein report a case of a jejunal mesenteric lymphangioma that was initially detected incidentally in an asymptomatic patient with a subsequent sudden increase in size with resulting surrounding mass effect after 9 months and a spontaneous partial regression at surgical resection. Our case is the first reported case which outlines a period in the natural history and evolution of microcystic mesenteric lymphangioma, illustrating the sudden enlargement likely attributable to spontaneous and self-limiting haemorrhage and subsequent partial regression at surgical resection. We thenceforth propose a possible management algorithm for adult patients with mesenteric lymphangiomas.

  • gastrointestinal surgery
  • medical management
  • radiology
  • small intestine
  • surgery
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Footnotes

  • Contributors DTMT and AYC performed the literature review and wrote up the article. BLF reviewed the histological images, provided input and wrote the histology reports. YYY provided the imaging and wrote the imaging reports. ELT oversaw and supervised the project. All authors were involved in the conception of the article and read and approved the final manuscript.

  • 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 for publication Obtained.

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

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