Cystic mass of the right iliac fossa: don't forget about lymphatic malformation

Abstract

Lymphatic malformation or cystic lymphangioma is a benign tumour of the lymphatic vessels. It is more commonly reported among children and has polymorphic clinical presentations. The diagnosis is based on imaging but requires histological confirmation. The treatment of choice is surgical excision for the abdominal and symptomatic localization. We report the case of a 30-year-old female who consulted for right iliac fossa pain mimicking an acute appendicitis. The physical examination revealed a slight tenderness in the right iliac fossa without fever or palpable mass. Though the biological screening was normal, the imaging exploration has revealed the presence of a multiloculated cyst located in the right iliac fossa at the ascending colon and measuring 15 cm. The mass matches with lymphatic malformation. Therefore, a laparoscopy was performed, and complete resection of the cystic tumor was accomplished with right hemicolectomy. The histologic exam has confirmed the diagnosis. Colonic lymphatic malformation is a rare and benign tumour, requiring a complete surgical excision to minimise any recidivism. The definitive diagnosis remains histological.