Cystic Lymphangioma of the Greater Omentum: A Case of Partial Spontaneous Regression and Review of the Literature

Introduction. Omental cysts are a part of cystic lymphangiomas and are benign proliferations of ectopic lymphatics without a communication with the normal lymphatic system. They commonly involve the neck in the pediatric population and are uncommon at other sites and occur rarely in adults. Case Pre...

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Main Authors: Haraesh Maranna, Lovenish Bains, Pawan Lal, Rahul Bhatia, Mohd Yasir Beg, Pritesh Kumar, Varuna Mallya
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2020/8932017
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author Haraesh Maranna
Lovenish Bains
Pawan Lal
Rahul Bhatia
Mohd Yasir Beg
Pritesh Kumar
Varuna Mallya
author_facet Haraesh Maranna
Lovenish Bains
Pawan Lal
Rahul Bhatia
Mohd Yasir Beg
Pritesh Kumar
Varuna Mallya
author_sort Haraesh Maranna
collection DOAJ
description Introduction. Omental cysts are a part of cystic lymphangiomas and are benign proliferations of ectopic lymphatics without a communication with the normal lymphatic system. They commonly involve the neck in the pediatric population and are uncommon at other sites and occur rarely in adults. Case Presentation. A 42-year-old female with complaints of vague lower abdominal pain for 8 months presented with a soft, nontender swelling of size 22×18 cm in the hypogastrium and umbilical region. Computerized tomography (CT) of the abdomen showed a peripherally enhancing hypodense cystic lesion of size 19×14×12 cm perhaps arising from the mesentery. The cyst had spontaneously reduced in size by about 70% over the next 4 months. During surgery, the cyst of size 10×9×8 cm was present in the greater omentum. Excision was done, and histopathology was suggestive of cystic lymphangioma. Discussion. Cystic lymphangiomas have an incidence of 1/20000 at infancy and 1/100000 to 1/250000 of hospital admissions in adults, and the female-to-male ratio is 2 : 1. In adults, they are found in the age group between 40 and 70 years. Spontaneous regression of omental cysts is very rare and presumably from increased pressure in cysts overcoming incomplete obstructions or by establishment of alternative routes of drainage. Conclusion. As the disease is essentially benign and if there are no significant pressure symptoms, the cysts of short duration can be watched further for regression. Long-standing, symptomatic cysts, nonregression, and diagnostic uncertainty will warrant surgery to confirm the diagnosis and relieve the symptoms.
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spelling doaj-art-883935444d84459aa4ef5307cbecdc0d2025-02-03T01:25:16ZengWileyCase Reports in Surgery2090-69002090-69192020-01-01202010.1155/2020/89320178932017Cystic Lymphangioma of the Greater Omentum: A Case of Partial Spontaneous Regression and Review of the LiteratureHaraesh Maranna0Lovenish Bains1Pawan Lal2Rahul Bhatia3Mohd Yasir Beg4Pritesh Kumar5Varuna Mallya6Department of Surgery, Maulana Azad Medical College, New Delhi, IndiaDepartment of Surgery, Maulana Azad Medical College, New Delhi, IndiaDepartment of Surgery, Maulana Azad Medical College, New Delhi, IndiaDepartment of Surgery, Maulana Azad Medical College, New Delhi, IndiaDepartment of Surgery, Maulana Azad Medical College, New Delhi, IndiaDepartment of Surgery, Maulana Azad Medical College, New Delhi, IndiaDepartment of Pathology, Maulana Azad Medical College, New Delhi, IndiaIntroduction. Omental cysts are a part of cystic lymphangiomas and are benign proliferations of ectopic lymphatics without a communication with the normal lymphatic system. They commonly involve the neck in the pediatric population and are uncommon at other sites and occur rarely in adults. Case Presentation. A 42-year-old female with complaints of vague lower abdominal pain for 8 months presented with a soft, nontender swelling of size 22×18 cm in the hypogastrium and umbilical region. Computerized tomography (CT) of the abdomen showed a peripherally enhancing hypodense cystic lesion of size 19×14×12 cm perhaps arising from the mesentery. The cyst had spontaneously reduced in size by about 70% over the next 4 months. During surgery, the cyst of size 10×9×8 cm was present in the greater omentum. Excision was done, and histopathology was suggestive of cystic lymphangioma. Discussion. Cystic lymphangiomas have an incidence of 1/20000 at infancy and 1/100000 to 1/250000 of hospital admissions in adults, and the female-to-male ratio is 2 : 1. In adults, they are found in the age group between 40 and 70 years. Spontaneous regression of omental cysts is very rare and presumably from increased pressure in cysts overcoming incomplete obstructions or by establishment of alternative routes of drainage. Conclusion. As the disease is essentially benign and if there are no significant pressure symptoms, the cysts of short duration can be watched further for regression. Long-standing, symptomatic cysts, nonregression, and diagnostic uncertainty will warrant surgery to confirm the diagnosis and relieve the symptoms.http://dx.doi.org/10.1155/2020/8932017
spellingShingle Haraesh Maranna
Lovenish Bains
Pawan Lal
Rahul Bhatia
Mohd Yasir Beg
Pritesh Kumar
Varuna Mallya
Cystic Lymphangioma of the Greater Omentum: A Case of Partial Spontaneous Regression and Review of the Literature
Case Reports in Surgery
title Cystic Lymphangioma of the Greater Omentum: A Case of Partial Spontaneous Regression and Review of the Literature
title_full Cystic Lymphangioma of the Greater Omentum: A Case of Partial Spontaneous Regression and Review of the Literature
title_fullStr Cystic Lymphangioma of the Greater Omentum: A Case of Partial Spontaneous Regression and Review of the Literature
title_full_unstemmed Cystic Lymphangioma of the Greater Omentum: A Case of Partial Spontaneous Regression and Review of the Literature
title_short Cystic Lymphangioma of the Greater Omentum: A Case of Partial Spontaneous Regression and Review of the Literature
title_sort cystic lymphangioma of the greater omentum a case of partial spontaneous regression and review of the literature
url http://dx.doi.org/10.1155/2020/8932017
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