J Gastric Cancer.  2011 Dec;11(4):243-247.

Giant Mesenteric Cystic Lymphangioma Originating from the Lesser Omentum in the Abdominal Cavity

• Kang BH
• Hur H
• Joung YS
• Kim DK
• Kim YB
• Ahn CW
• Han SU
• Cho YK

Abstract

A 48 year old woman was diagnosed with a huge cystic mass in her abdominal cavity. She complained of significant abdominal discomfort due to the mass. The abdominal computed tomography revealed a giant multi-lobulated mass, measuring 26x12 cm in size, adjacent to the lesser curvature of the stomach. In the operation field, the mass was found to originate from the lesser omentum, including the right and left gastric vessels and the vagus nerves, and to invade the lesser curvature of the stomach. For curative resection, distal subtotal gastrectomy with mass excision followed by gastroduodenostomy were performed. This mass was pathologically diagnosed to be a mesenteric cystic lymphangioma; in fact, the largest ever reported. The patient had no complications during the postoperative period and was discharged from the hospital on the seventh day after surgery.

Keyword

Lymphangioma; Gastrectomy; Omentum

MeSH Terms

Abdominal Cavity
Female
Gastrectomy
Humans
Lymphangioma
Mesenteric Cyst
Omentum
Postoperative Period
Stomach
Vagus Nerve

Figure

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  Fig. 1 Findings of the computed tomography analysis. (A) A multi-lobulated cystic mass was observed to extend into the pelvic cavity. (B) This mass originated from the lesser omentum, including the truncal vagus.

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  Fig. 2 Gastrofiberscopic findings showing the narrowing of the stomach lumen by the extrinsic compression of the lesser curvature. However, the mucosa was intact.

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  Fig. 3 Photo of the macrosopic findings of the specimen. (A) Transected tumor showing the multilobulated cystic tumor, including the partially solid portion. (B) The s tomach specimen showed normal mucosa after opening of the greater curvature.

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  Fig. 4 Photo of the microscopic finding of the specimen. (A) The tumor was composed with multiple cysts of various size (Hematoxylin-Eosin Stain, ×40). (B) Each cyst was lined with the flat endothelial cells, and filled proteinaceous material. Several inflammatory cells were observed in the intercystic space (Hematoxylin-Eosin Stain, ×200).

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