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Cystic Hygroma

Cystic hygromas are multiloculated cystic structures that are benign in nature. Cystic hygromas are anomalies of the lymphatic system characterized by single or multiple cysts within the soft tissues, usually involving the neck. Large cysts present at birth may necessitate a tracheostomy if there is pressure on the airway, though this is rare. we studied 15 consecutive cases of nuchal hygroma detected prenatally by ultrasound. Lymphatic channels are formed from a series of clefts that develop in the mesenchyme around the sixth week of gestation. embryonic mid-gut herniation is usually reduced by 11 weeks, so care should be taken not to confuse physiological gut herniation at this age with an omphalocele. Larger cysts which continue to grow may need to be actively treated. Eleven fetuses (73 per cent) had karyotypes consistent with Turner's syndrome, and an additional fetus with female genitalia had a 46,XY karyotype On completion of the Sonographer's examination, the obstetrician gave the patient the option of having an amniocentesis to determine the presence of chromosomal abnormalities. However, due to the high perinatal mortality rate the couple chose to terminate the pregnancy. Surgical reduction of these lesions in either the mouth or neck may also be helpful Failure to establish venous drainage results in dilated disorganized lymph channels, which, in the largest form, present as cystic hygromas.

A cystic hygroma is a thin-walled, sac-like structure filled with lymph. They form as the result of budding lymphatics and, thus, may occur anywhere in the body, although they are most frequently encountered in the neck (75%) and axilla (20%). Thirteen fetuses were hydropic at the time of diagnosis; nine either died or were bradycardic in utero before abortion; one died a few hours after birth It occurs most commonly in the head and neck area and often appears as a soft bulge under the skin. Cystic hygromas are caused by a delay or absence of the communication between the jugular lymph sacs and the internal jugular veins during fetal development. Other theories for the development of cystic hygromas include the possible abnormal sequestration of embryonic lymphatic tissue that does not communicate with normal lymph-flow channels and the budding of lymphatics that canalize to form lymph-filled cysts. An alternative treatment has been to use an attenuated bacteria (OK432) as an injection into the cysts, which causes a local sclerosing reaction which may help to reduce the size of the lesions

Causes of Hygroma

Common causes of Hygroma :

  • This condition is a congenital (present before birth) abnormality caused by embryonic lymphatic tissues.
  • It occurs as the baby grows in the womb from pieces of material that carries fluid and white blood cells (embryonic lymphatic tissue).
  • A lymphatic malformation is a congenital (present from birth) defect that occurs during early embryonic development when the lymphatic vessels do not properly form.
  • Cystic hygromas are abnormal growths arising from these tissues.

Symptom of Hygroma

Some Symptoms of Hygroma :

  • A common symptom is a neck mass noted at birth, or discovered later in an infant after an upper respiratory tract infection.
  • Ultrasound
  • CT scan
  • Painless lesion unless infected or bleeding
  • Chest x - ray
  • A large, fluid-filled mass to the lower side and back of the neck under the platysma muscle (a thin, flat muscle that extends from the upper chest to the jaw)

Treatment of Hygroma

The most importent Treatment of Hygroma :

  • Bleomycin is a poor choice because of its toxicity (pulmonary fibrosis) and because it scars the area, making surgical dissection more difficult.
  • If unresectable lesions are small cysts, they may not respond to sclerosis.
  • These include injection of sclerosing agents, steroids, chemotherapy agents, and radiation therapy.
  • However, cystic hygromas can often invade other neck structures, making this impossible.
  • your child's tolerance for specific medications, procedures, or therapies
  • This approach currently is performed only experimentally and requires further study to document its safety and efficacy


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