Cystic lymphangioma of the pancreatic head treated by enucleation: Case report and literature review. (October 2022)

• Record Type: Journal Article
• Authors: Almeida, Miguel; Rama, Tiago F.; Quintanilha, Rui; Mendes, Joana; Carneiro, Vitor
• Is Part Of: International journal of surgery case reports. Volume 99(2022)
• Publication Date: 2022-10
• Subjects: Incidentaloma -- Cystic lymphangioma -- Pancreas -- D2-40 -- Local excision -- EUS; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2022.107715
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction: The widespread use of imaging methods has led to an increased identification of asymptomatic Pancreatic Cystic Lymphangiomas (PCL), a rare entity for which available information is very limited. Presentation of case: We present the case of an asymptomatic 61-year-old male, submitted to elective enucleation of a pancreatic head PCL at our institution. After four years of follow-up the patient is doing well and has no clinical or imaging signs of recurrence. Discussion: Though rare, PCL should be included in the differential diagnosis of pancreatic cystic neoplasms. All efforts should be made to ascertain a preoperative diagnosis, as expectant follow-up could be a reasonable approach in asymptomatic patients and/or poor surgical candidates. In the face of an uncertain diagnosis, complete surgical excision may be the treatment of choice. Conclusion: The medical community worldwide should be encouraged to report all cases of PCL, as to increment the overall knowledge about this lesion. Highlights: Widespread use of cross-sectional imaging increased identification of asymptomatic pancreatic cystic lesions. Pancreatic Cystic Lymphangioma is one of those rare cystic neoplasms for which available information is very limited. Definitive diagnosis often requires pathologic examination of surgical specimen, immunohistochemically with positivity for D2-40. En bloc resection with negative margins is curative, however, treatment for asymptomatic cystic lymphangiomas is still controversial.