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Contrast-enhanced computed tomography scan. Superiorly, this revealed a mixed attenuation, mainly cystic mass with a solid component within its left lateral aspect (arrow). More inferiorly, the lesion was of a more fluid density (arrowhead). These characteristics suggested a teratoma or congenital cystic adenomatoid malformation rather than cystic hygroma as the working diagnosis.
Source publication
Cystic hygroma is a benign congenital neoplasm that mostly presents as a soft-tissue mass in the posterior triangle of the neck. Pure mediastinal lesions are uncommon; the vast majority are asymptomatic and are an incidental finding in adulthood. The diagnosis is often made intra- or postoperatively. Prenatal identification is exceptional and post-...
Citations
... They may be identified as incidentalomas during radiological screening or may present with compressive manifestations. [7,8] Our case shows that intrathoracic cystic hygroma may present with sudden respiratory distress in a previously asymptomatic child. This is because a softened tracheal wall (as a result of compression by the tumour) is susceptible to sudden collapse when it is subjected to significant negative intrathoracic pressures. ...
Benign cystic lesions such as cystic hygroma commonly manifest as progressively increasing swelling in the neck with or without compression effects. Rarely, they present with sudden respiratory distress in instances such as infection or haematoma resulting in a sudden increase in the size of the tumour. We present a seven month old child with sudden onset respiratory distress without any obvious neck swelling. The chest X ray findings correlated with the history and were suggestive of right upper lobe pneumonia that leads to a wrong diagnosis of aspiration pneumonia. However, presence of a deviated trachea in the neck raised a suspicion of possible mass. Computed tomogram showed a large cystic mass in the right upper mediastinum with tracheal collapse. We caution intensivists and paediatricians that sudden respiratory distress in infants in the absence of obvious neck swelling does not rule out possibility of intrathoracic tumour.
Localization of a microcystic lymphatic malformation within the diaphragm is an extremely rare vascular anomaly of the lymphatic system. We report the case of a 3-year-old boy who had a localized intrathoracic mass that was detected after birth. As the feeding artery to the mass was detected on computed tomographic images before surgery, we suspected the mass to be an extralobar pulmonary sequestration. Thoracoscopic findings indicated that the mass was localized within the left diaphragm and had an indiscrete margin with the diaphragm. An excisional biopsy was performed to avoid resection of the diaphragm itself. The mass was diagnosed as a microcystic lymphatic malformation based on pathological findings. When an accurate diagnosis of the mass within the diaphragm cannot be made preoperatively, a biopsy under thoracoscopic surgery may be an effective method to diagnose microcystic lymphatic malformations.
Objective:
Our aim was to determine the supplemental value of MRI in fetal abdominal disease detected on prenatal sonography.
Conclusion:
Our preliminary results suggest the primary supplemental value of MRI relative to sonography in fetal abdominal disease lies in improved tissue characterization rather than in improved anatomic characterization.
