Surgical Management of an Extensive Axillary Cystic Hygroma in a 4 Day Old Neonate: A Case Report

Abstract

Cystic hygroma is a benign developmental malformation of the lymphatic system resulting from a lack of communication between the lymphatic and venous systems. Most common site of occurrence of a cystic hygroma is the neck (about 75%) followed by the axilla (20%) and about 1% in the mediastinum, groin and retroperitoneum. Small, simple cystic hygromas can be managed conservatively, whereas massive, complex cystic hygromas most often need surgical intervention. Patient-specific multidisciplinary approach, involving obstetrician, radiologist, paediatrician, paediatric surgeon (where available) and plastic surgeon, is advised in cases where extensive cystic hygromas are diagnosed pre-natally. Here we have a case of a neonate born with an extensive cystic hygroma in the left axillary region extending medially onto the chest wall upto the 8th rib and laterally till elbow that was managed via careful planning and surgical excision, while safeguarding the underlying muscular and neurovascular structures, followed by reconstruction.