Cystic lymphangioma of hepato-gastric ligament: a rare case of neoplasia in adults

Materials and methods FE, a man of 71 years, comes to our attention in July 2009 complaining about one month from the onset of dyspeptic disorders and a sense of weight reported in epigastrium. In his history, in addition to this, the patient reported the removal of a cystic lymphangioma in the left cheek a few years before. On physical examination, in the right hypochondriac region, there is the presence of swelling of tense-elastic consistency, mobile on superficial and deep plans and painless, about 10 cm in maximum diameter. Ultrasound, CT and MRI documented the presence of an oval formation, with cystic charateristics 144x68 mm in diameter that extends caudally to about 10 mm in the context of the peritoneum in close proximity with the front lower edge of the small wing of the liver and the gastric body. The patient underwent exploratory laparotomy, where we found a massive lesion, well encapsulated, of elastic consistency, brown stalk, originating from the hepato-gastric ligament and we proceed with the removal of the mass “en bloc” after ligation of the vascular pedicle. No additional excision was necessary. The histological examination demonstrated a cystic lymphangioma. The postoperative course was regular, the patient was discharged on the third day. After six months of follow up the patient is disease free.