Mediastinal Hodgkin lymphoma arising from cystic lymphangioma: case report in a child.

Mediastinal disease is a frequent clinical presentation in children with Hodgkin lymphoma. It is usually due to mediastinal lymphadenopathy or involvement of the thymus gland. Cystic lymphangiomas are benign tumors of the lymphatic system, and less than 1% present as a solitary mediastinal mass. To our knowledge, there has been no report in the literature describing Hodgkin lymphoma arising from cystic lymphangioma. In this report, we describe a patient with mediastinal cystic lymphangioma, from which Hodgkin lymphoma was determined to have arisen.

Infected giant lymphangioma circumscriptum treated with a combination therapy.

Lymphangioma circumscriptum is an uncommon benign disorder of skin and subcutaneous tissues characterized by dilated lymphatic channels. It is an uncommon vascular tumor and it rarely becomes infected. We report a 20-year-old man who had an infected giant tumor in his left thigh. After an extensive resection and radiofrequency energy therapy, he recovered well with an acceptable cosmetic result. We followed up the patient for 2 years without any recurrence.

Radiotherapy in congenital vulvar lymphangioma circumscriptum.

Congenital lymphangioma circumscriptum (LC) of the vulva is a rare disorder with unknown etiology. Treatment options include ablative approaches such as laser therapy, sclerotherapy, and surgery. Radiotherapy has been shown to be effective in the management of congenital lymphangioma especially in the thoracic and abdominal lesions. In this report, we describe a patient with persistent vulvar LC despite sclerosing therapy and several surgical excisions. She was treated with a course of external radiotherapy and showed a dramatic objective response with relief of all symptoms.

Lymphangioma Circumscriptum Post Radiotherapy for Penile Cancer Treated with CO2 Laser.

Lymphangioma circumscriptum (LC) is a rare, benign condition, predominantly characterized by the malformation of lymphatic skin vessels. Its onset may be congenital or due to secondary causes such as radiotherapy, infections, or surgical procedures. We present the case of a 55-year-old patient with a pathologic history of squamous cell carcinoma of the penis followed by radical penectomy. Due to metastasis to the locoregional lymph nodes, the entire affected area was subsequently treated with radiation therapy, receiving a total dose of 55.8 Gray. Eight years after this treatment, translucent vesicles filled with a clear liquid appeared on the scrotum. Histopathology confirmed the diagnosis of LC and therapy with CO2 laser was applied, resulting in a favorable outcome. LC of the scrotum may present a long-term radiotherapy-induced complication of this site. Our clinical experience showed that the CO2 laser was the therapy of choice as the vesicles entirely disappeared and healed as white scar-like lesions.

Evaluation of a New Method for the Treatment of Invasive, Diffuse, and Unexcisable Lymphangiomas of the Oral Cavity with Defocus CO2 Laser Beam: A 20-Year Follow-Up.

OBJECTIVE: The aim of our study is to evaluate the efficiency of a new therapeutic method using CO2 laser to avoid mutilation or total excision for the treatment of invasive, large and unexcisable oral lymphangiomas. BACKGROUND DATA: Cystic lymphatic malformations, or lymphangiomas, are mature lymphatic malformations, consisting of abnormal lymphatic vessels. Surgical excision is considered by most surgeons to be the treatment of choice for lymphangioma. Laser beam has been used to treat superficial or small lymphatic malformations by excision or by photocoagulation, and to excise or photocoagulate small lymphangiomas. PATIENTS AND METHODS: Seventeen patients with diffuse and unexcisable lymphangiomas were treated using a CO2 laser with specific settings: beam was 2 W in noncontact and defocus mode, power density was 0.63 W/cm2 for irradiation time in the range of 3-5 min, and the estimated energy density range was 114.65-191.02 J/cm2. The beam diameter at the tissular impact point was ±2 cm. The laser beam was defocused to provoke a deep heat generation that would dry up the lymphatic tissues and induce deep tissue necrosis that heals by fibrous tissue process. RESULTS: The results were satisfactory and stable, with localized recurrence in three cases. The recurrent areas were re-treated using the same technique successfully and with no further recurrence. CONCLUSIONS: The use of CO2 laser under the suggested irradiation conditions can be considered a useful technique for the treatment of invasive lymphangiomas.

Treatment of hemorrhagic lymphatic malformation of the tongue with a pulsed-dye laser.

Hemorrhagic lymphatic malformation (formerly called hemolymphangioma) of the tongue is an uncommon malformation that may pose both functional and cosmetic problems for the patient. The challenge has been to find a conservative treatment with low morbidity and better results than those achieved with surgical excision, which has been the mainstay of therapy. We report a case of successful treatment of a hemorrhagic lymphatic malformation of the tongue with a variable-pulse 595-nm pulsed-dye laser (Vbeam; Candela Corp, Wayland, Mass). In this patient, pulsed-dye laser treatment of the hemorrhagic lymphatic malformation achieved satisfactory functional and cosmetic outcomes. Its use in superficial vascular lesions of the mucosa should be considered.

Mediastinal lymphangioma and chylothorax: the role of radiotherapy.

An 11-year-old boy with a capillary/cystic lymphangioma of the posterior mediastinum is described, in whom a symptomatic chylothorax proved to be refractory to surgical management. The addition of low dose mediastinal radiotherapy (2,000 cGy/10 fractions) resulted in prompt and permanent resolution of the chylothorax. Although operation is the primary modality of treatment for these lesions, the addition of radiotherapy in such refractory patients appears to be well tolerated and efficacious and should result in few long-term complications.

Lymphangiolipoma of the lower extremity: 5-year radiological follow-up after radiotherapy treatment.

This report describes a lymphangiolipoma located in the extremity in a young woman. Radiotherapy effectively controlled recurrent lymphangiolipoma of the left upper leg that had been judged inoperable by limb-sparing surgical resection. In the case presented here, a dose of 50 Gy in 25 fractions over 5 weeks was employed without long-term complications after 5-year follow-up.

Case report: mesenteric mixed haemangioma and lymphangioma; report of a case with 10 year follow-up after radiation treatment.

A patient with massive mixed haemangioma and lymphangioma of the mesentery first presented in childhood with ascites which subsided spontaneously and, subsequently, at 21 years of age, presented with gastrointestinal bleeding. At laparotomy, the lesion was found to involve 90% of the mesentery and was unresectable due to its bulk. Hence he was treated by radiotherapy (15 Gy/15 fractions/3 weeks followed by a boost of 5 Gy/4 fractions/4 days). He responded to the treatment. 10 years later he again experienced mild gastrointestinal bleeding which subsided spontaneously. This case illustrates the efficacy of radiotherapy in massive mesenteric haemolymphangiomas. Review of the literature revealed that surgical excision, embolization, and radiotherapy have been used in the treatment of haemangiomas and lymphangiomas. In unresectable cases, radiotherapy has a definite role in the management. A variety of doses has been employed in the literature. No definite dose-response relationship was identified.

Radiotherapy is a useful treatment for lymphangioma circumscriptum: a report of two patients.

Lymphangioma circumscriptum is a rare non-malignant skin tumour, conventionally treated by surgical resection, but with variable results. We report two cases, which, although unsuitable for excision, were treated successfully by radiotherapy and consider the place of this modality in managing this disorder. We conclude that radiotherapy is an effective treatment for unresectable lesions, or for patients who are unwilling to consider surgery.

Successful control of extensive thoracic lymphangiomatosis by irradiation.

Lymphangiomas are very rare benign tumours, believed to arise from congenital malformations of the lymphatic system. They grow very slowly, but are capable of massive expansion and infiltration of the surrounding tissues. If left untreated they can cause serious and sometimes fatal complications. The thorax is commonly affected, with involvement of the ribs, pleura, pericardium, lung parenchyma, mediastinum and vertebrae. Treatment depends on the extent of the disease. While local excision is the treatment of choice for localized lesions, radiotherapy is used for more extensive disease. In this report we describe three patients with extensive thoracic lymphangiomatosis who were treated successfully with irradiation alone. The value of early diagnosis and treatment is emphasized.

[Abdominal organ-transcending tumors with special reference to peritoneal carcinosis. CT versus the surgical site]. / Abdominelle organüberschreitende Tumoren unter besonderer Berücksichtigung der Peritonealkarzionose. CT versus Operationssitus.

In 41 patients with a histologically confirmed peritoneal carcinomatosis (n = 29) or lymphangiomatosis (n = 12) the preoperative CT investigations of the abdomen were compared with intraoperative findings. CT findings were differentiated between direct or indirect signs. The sensitivity of the various CT signs of peritoneal carcinomatosis or lymphangiomatosis was between 66 and 100%. Abdominal CT studies proved to be a reliable preoperative method if the findings were examined closely. A precise review even of indirect signs is of high diagnostic value.

A case of cystic lymphangioma extending from the neck to the tongue. Management of the lesion remaining after surgery.

A case of cystic lymphangioma in a child is reported. The lesion extended bilaterally from the neck to the tongue. Complete removal of the tumour in the floor of the mouth and the tongue was impossible. Later, swelling in these regions caused dyspnoea. The residual lesion was treated by external irradiation (60 Co total dose of 30 Gy). During a three-year follow-up period, no recurrence of the swelling, respiratory distress, or side-effects of radiation were observed.

Lymphangioma. A long-term follow-up study.

At the Hospital for Sick Children 177 patients with lymphangioma, exclusive of those who had intra-abdominal lesions, were seen between 1927 and 1964. Forty-nine of these (aged 8 to 41 years) were available for follow-up examination. The results of treatment by surgical excision, aspiration, incision and drainage, and radiation are reported. No cases confirmed histologically as lymphangioma underwent spontaneous regression. Two histologically unconfirmed cases underwent partial regression. Four of the 11 who were left with lymphangioma tissue at operation never had significant recurrences. Therefore, this clinical study does not clarify the possible role of spontaneous regression in lymphangioma. Extensive surgery is the treatment of choice whenever feasible, but in unilocular or bilocular cystic lymphagnioma subsequent regression can be expected after palliative treatment (aspiration, or incision and drainage). Clinical and pathological criteria should be established for differentiation between lymphangioma and primary lymphedema. Lesions involving subepithelial, subdermal, and subcutaneous or internodal networks of lymphatics will produce lymphagioma; lesions of the collecting lymphatic trunks will result in lymphedema.

Lymphangiomas involving the ovary. Report of a case and review of the literature.

Lymphangioma involving the ovary is an extremely rare tumor. There are only 8 cases documented in the literature. This report describes a case of peritoneal lymphangiomatosis which presented as an apparent ovarian tumor and rapidly recurred and spread into adjacent and distant peritoneal organs following oophorectomy. We will comment on its complete response to irradiation treatment and review the literature.

Response to radiation therapy of recurrent lymphangioma in a dog.

A recurrent lymphangioma in a 5-year-old Airedale Terrier was treated successfully with cobalt-60 radiation. The neoplasm had been excised twice before being treated with radiation.