2019 Volume 55 Issue 5 Pages 988-992
The patient was a 17-year-old male. A congenital giant cystic lesion on the neck was detected prenatally, and he was diagnosed as having cervical cystic lymphatic malformation postnatally. Two rounds of sclerotherapy were performed during infancy. The cyst size was markedly reduced. At 4 years of age, he underwent surgical removal of the excess skin at the Department of Plastic Surgery, and the swelling in the neck improved. Thereafter, he discontinued outpatient visits on his own and no follow-up was conducted. When he had a fracture of the cervical spine during baseball practice at 17 years of age, multiple cystic lesions in the bone were detected. MRI indicated no recurrence of the cervical cystic lesion but multiple cystic lesions in the cervical spine, thorax, ribs, iliac bone, and spleen were detected; thus, he was diagnosed as having generalized lymphatic anomaly (GLA). Bone union occurred later at the fracture site of the cervical spine. No pleural effusion, cardiac effusion, or ascites were noted, and blood analysis showed no abnormality. Therefore, he is currently under follow-up with no treatment. Cystic lymphangioma is currently defined as lymphatic malformation due to developmental disorders of lymphatic vessels. The present case was classified as a macrocystic-type lymphatic malformation and considered to belong to a disease group different from GLA, which is a systemic disease. However, GLA may develop during the course, as in this case, and long-term follow-up in addition to diagnosis and treatment may be warranted.
