TEDAVİYE YANIT VERMEYEN KABAKULAK: KİSTİK HİGROMA OLGUSU

Abstract

Konjenital lenfatik malformasyon olan kistik higroma, çoğunlukla servikal bölge yerleşimli olup kistik lenfanjiyom olarak da adlandırılır. Oluşumu hakkında brankiyal yapıların inkomplet kapanması, lenf nodunda tükrük bezi inklüzyonu veya her iki durumun birlikte rol oynadığı iddia edilmektedir. Ayırıcı tanıda; tüberküloz lenfadenit, lipoma, kistik higroma, metastatik tümörler, lenfoma, süpüratif lenfadenitler, hemanjiom, lenfanjiom, laringosel ve ranulanın dikkate alınması gerekir. Tedavisi, cerrahi eksizyondur. Bu çalışmada kulak altında kitle şikâyeti ile kabakulak tedavisi gören fakat iyileşmeyince yanlış tanı aldığı fark edilip sevk edilen bir vakayı sunduk. Hastanın manyetik rezonans görüntülemesi yapıldı. Kistik higroma ile uyumlu kitle saptandı ve cerrahiye sevk edildi.

Keywords

• Kistik higroma
• kabakulak
• lenfatik malformasyon

MUMPS NOT RESPOND TO TREATMENT: A CASE OF CYSTIC HYGROMA

Abstract

Cystic hygroma named as cystic lymphangioma is a congenital lymphatic malformation and usually located in the cervical location. They are clinically apparent in late childhood or early adulthood. Theories have been proposed regarding the incomplete obliteration of branchial structures or salivary gland inclusion in lymph nodes or together. The clinical differential diagnoses of these lesions include tuberculous lymphadenitis, lipoma, lymphoepithelial cysts, metastatic neoplasms, lymphomas, suppurative lymphadenitis, hemangioma, lyphangioma, laryngocele and ranula. The treatment is surgical excision. In this study, we present a case of incorrect diagnosis. Patient whose mass under the ear treated as mumps. But the patient did not respond to treatment. The patient was so referred. Magnetic resonance imaging of the patient were performed. Mass was compatible with cystic hygroma and was referred for surgery.

Keywords

• Cystic hygroma
• mumps
• lymphatic malformation

References

1. Kennedy TL, Whitaker M, Pellitteri P, et al. Cystic hygroma / lympangioma: A rational approach to management. Laryngoscope 2001; 111: 1929- 37.
2. Dahnert W. Radiology review manual. 3th ed. Baltimore: Williams – Wilkins 1996; 285.
3. Zanotti SD, LaRusso S, Coulson C. Prenatal sonographic diagnosis of axillary cystic lymphangiomas. J Clin Utrasound 2001; 29: 112-5.
4. Toi A. The fetal face and neck. In: Rumack CM, Wilson SR, Charboneau JW. Diagnostic ultrasound. 2th ed. St. Louis: Mosby 1998; 1247-48.
5. Ardenghy M, Miura Y, Kovach R, et al. Cystic hygroma of the chest wall: A rare condition. Ann Plast Surg 1996; 37: 211.
6. Orvidas LJ, Kasperbauer JL. Pediatric lymphangioma of the head and neck. Ann Otol Rhinol Laryngol 2000; 109: 411-21.
7. Muensterer OJ. Index of suspicion. Case 2: Cystic Hygroma. A. Esin Kibar. Ayın olgusu: Göğüs duvarında KH Pediatrics in Review 2000; 21: 141- 3.
8. Sarin YK. Cystic hygroma. Indian Pediatr 2000; 37: 1139-40.

9. Wright CC, Cohen DM, Vegunta RK, et al. Intrathoracic cystic hygroma: a report of three cases. J Pediatr Surg 1996; 31: 1430- 2.
10. Fonkalsrud EW. Congenital malformations of the lymphatic system. Semin Pediatr Surg 1994; 3: 62- 9.
11. Kocher HM, Vijaykumar T, Koti RS, et al. Lymhangioma of the chest wall. J Postgrad Med 1995; 41: 89- 90.
12. Fleischer AC, Manning FA, Jeanty P, Romero R. Sonography in obstetrics and gynecology. 5th ed. London: Appleton Lange, 1996; 393-394.
13. American Academy of Pediatrics [Mumps]. In: Pickering LK, Baker CJ, Long SS, McMillan JA, eds. Red Book: 2006 Report of the Committee on Infectious Disease. 27th ed. Elk Grove Village, IL: American of Pediatrics 2006: 464-8.
14. Gupta RK, Best J, McMahon E. Mumps and the UK epidemic 2005. BMJ 2005; 330: 1132- 5.
15. Zadvinskis DP, Benson MT, Kerr HH, et al. Congenital malformations of the cervicothoracic lymphatic system: embryology and pathogenesis. RadioGraphics 1992; 12: 1175-89.
16. Kibar AE, Çakır BÇ, Tiryaki T ve ark. Göğüs duvarında kistik higroma: Nadir bir yerleşim yeri. Türk Pediatri Arşivi 2005; 40: 241-3.
17. Emery PJ, Bailey CM, Evans JNG. Cystic hygroma of the head and neck. J Laryngol Otol 1984; 98: 613-9.
18. Cohen MD, Edwards MK. Magnetic resonance imaging of children. Philadelphia: Decker 1990; 758.