Author:
Wu Wei,Mo Jiayu,Tan Kezhe,Chen Xingzhao,Xu WeiJue,Liu JiangBin,Lv Zhibao
Abstract
Abstract
Background
Scrotal and retroperitoneal lymphangioma (SRL) in children is relatively rare and its clinical symptoms are usually difficult to distinguish from other conditions such as hydrocele and incarcerated inguinal oblique hernia. This study aimed to explore the clinical diagnosis and treatment of abdominal scrotal lymphangioma in children, and thus, to increase our understandings of this disease in clinical practice.
Method
This study enrolled nine boys, aged 1–10, who were admitted to Shanghai Children’s Hospital from January 2019 to December 2020 and who were finally confirmed with lymphangioma in the inguinal area. The clinical manifestations, diagnosis, and treatment of these children were analyzed retrospectively. The length of diagnostic process ranged from 3 weeks to 20 months. We also reviewed other cases of initially misdiagnosed cases of SRL in English publications from 2000 to 2022.
Results
The nine cases were misdiagnosed as hydrocele, hematoma, or inguinal hernia. Three patients received intracystic injection of bleomycin, three underwent laparoscopic mass resection, and three underwent resection of the inguinal lymphangioma under direct vision. Postoperative pathological analysis of the surgical specimens confirmed the diagnosis of benign cystic lesions and lymphangioma. Meanwhile, among the 14 cases of SRL in literature review, eight were misdiagnosed. Six were initially diagnosed as hydrocele, one as inguinal oblique hernia, and one as testicular tumor, all of which underwent ultrasonography scans. All cases were confirmed as lymphangioma after pathological examination.
Conclusion
The non-specific clinical manifestations may contribute to the misdiagnosis of scrotal masses in children. A detailed and accurate medical history, careful physical examination, and imaging findings are important factors contributing to the preoperative differential diagnosis of scrotal lumps in children, but the final diagnosis is based on pathological examination.
Publisher
Springer Science and Business Media LLC
Subject
Pediatrics, Perinatology and Child Health
Reference34 articles.
1. Budhiraja S, Rattan KN, Gupta S, Pandit SK. Abdomino-scrotal lymphangioma. Indian J Pediatr. 1997;64(5):720–2.
2. Patoulias I, Prodromou K, Feidantsis T, Kallergis I, Koutsoumis G. Cystic lymphangioma of the inguinal and scrotal regions in childhood - report of three cases. Hippokratia. 2014;18(1):88–91.
3. Parakh A, Dubey AP, Garg A, Khurana N, Aggarwal SK. Cystic lymphangiomatous hamartoma masquerading as massive Ascites. Indian J Pediatr. 2009;76(7):753–4.
4. Al-Jabri T, Gruener AM. A rare case of lymphangioma of the scrotum in a 3 year old boy: a case report. Cases J. 2009;2:183. Published 2009 Nov 3.
5. Ali AY, Abdi AM, Basar D, Mohamed SS, İbrahim İG. Rare case cystic scrotal lymphangioma presented as a hydrocele. Int J Surg Case Rep. 2022;93:106959.