Gallbladder fossa lymphangioma encasing the common bile duct: a case report and review of the literature.

Introduction: Lymphangiomas are rare low-flow lymphatic vessel malformations mostly diagnosed in childhood. Among the abdominal lymphangiomas, the gallbladder lymphangioma is a rare presentation, and only a few cases have been reported till date, of which majority were cystic lymphangiomas. Case presentation: The authors present a case of a 48-year-old female with abdominal pain and normal physical examination and laboratory findings. On the performed imaging, a multiloculated cystic lesion, located in the gallbladder fossa, was found. The patient underwent open cholecystectomy, and surprisingly, the cyst extended to the common bile duct, which was separated cautiously. The cyst was resected, and the histopathological findings confirmed cystic lymphangioma. Conclusion: The cystic lymphangioma of the gallbladder can be asymptomatic, although most of the literature has reported abdominal pain. The diagnosis of lymphangioma is complicated, especially when intra-cystic hemorrhage happens. Ultrasonography, computed tomography, and magnetic resonance imaging are usually performed. The surgical excision of the cyst and the gallbladder is the treatment of choice. Although bile duct involvement is extremely rare, it should be considered during the surgery.

Pedunculated focal nodular hyperplasia of the liver in a healthy child born following in vitro fertilization: a case report and review of the literature.

BACKGROUND: Focal nodular hyperplasia is a common nonmalignant liver mass. This nonvascular lesion is an uncommon mass in children, especially those with no predisposing factors, namely radiation, chemotherapy, and hematopoietic stem cell therapy. Exophytic growth of the lesion further than the liver margins is not common and can complicate the diagnosis of the lesion. This report observes a focal nodular hyperplasia as a pedunculated lesion in a healthy child. CASE PRESENTATION: We describe a 9-year-old healthy Persian child who was born following in vitro fertilization complaining of abdominal pain lasting for months and palpitation. Employing ultrasound and computed tomography, a mass was detected in the right upper quadrant compatible with focal nodular hyperplasia imaging features. The child underwent surgery and the mass was resected. CONCLUSION: Diagnosing focal nodular hyperplasia, especially pedunculated form can be challenging, although magnetic resonance imaging with scintigraphy is nearly 100% sensitive and specific. Thus, a biopsy may be needed to rule out malignancies in some cases. Deterministic treatment in patients with suspicious mass, remarkable growth of lesion in serial examination, and persistent symptoms, such as pain, is resection, which can be done open or laparoscopic.