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Background <p>Cervical lymphangioma is a rare benign congenital malformation of the lymphatic system, most commonly diagnosed in early childhood. Adult presentations are extremely uncommon, with fewer than 100 cases reported in the literature.</p> Case Presentation <p>We report a unique case of a 49-year-old male with a 20-year history of a slowly progressive left submandibular swelling, later complicated by hoarseness of voice due to laryngeal extension. The lesion, consistent with a cystic hygroma (macrocystic lymphangioma), presented atypically in terms of patient age, symptomatology, and anatomical site. Imaging revealed a multiloculated cystic lesion extending from the submandibular region into the pre-epiglottic space, obscuring the left vocal folds. Surgical excision was performed, including the laryngeal extension, with an uneventful postoperative course and no recurrence at one-year follow-up.</p> Discussion <p>Adult-onset lymphangiomas are rare and may result from trauma or infection, with potential for insidious progression and airway compromise if left untreated. Laryngeal involvement is especially uncommon and presents unique diagnostic and surgical challenges. While sclerotherapy remains a therapeutic option, surgical excision is the preferred treatment, particularly for large or infiltrative lesions, due to lower recurrence rates and reduced risk of airway compromise.</p> Conclusion <p>This case underscores the importance of considering lymphangioma in the differential diagnosis of adult neck masses. Early imaging and individualized management are essential for favorable outcomes, especially when lesions exhibit atypical presentations or involve vital structures like the airway.</p>

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An Unusual Encounter with a Usual Suspect: Cervical Lymphangioma a Rare Presentation

  • 期刊论文

  • 发表日期：

    2025年8月8日

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  • Kiran Kumar Prathipati,
  • Sanskriti Jaiswal,
  • K. Khadeeja

摘要

Background

Cervical lymphangioma is a rare benign congenital malformation of the lymphatic system, most commonly diagnosed in early childhood. Adult presentations are extremely uncommon, with fewer than 100 cases reported in the literature.

Case Presentation

We report a unique case of a 49-year-old male with a 20-year history of a slowly progressive left submandibular swelling, later complicated by hoarseness of voice due to laryngeal extension. The lesion, consistent with a cystic hygroma (macrocystic lymphangioma), presented atypically in terms of patient age, symptomatology, and anatomical site. Imaging revealed a multiloculated cystic lesion extending from the submandibular region into the pre-epiglottic space, obscuring the left vocal folds. Surgical excision was performed, including the laryngeal extension, with an uneventful postoperative course and no recurrence at one-year follow-up.

Discussion

Adult-onset lymphangiomas are rare and may result from trauma or infection, with potential for insidious progression and airway compromise if left untreated. Laryngeal involvement is especially uncommon and presents unique diagnostic and surgical challenges. While sclerotherapy remains a therapeutic option, surgical excision is the preferred treatment, particularly for large or infiltrative lesions, due to lower recurrence rates and reduced risk of airway compromise.

Conclusion

This case underscores the importance of considering lymphangioma in the differential diagnosis of adult neck masses. Early imaging and individualized management are essential for favorable outcomes, especially when lesions exhibit atypical presentations or involve vital structures like the airway.