A rare case of cystic hygroma in Neck and extending into tho
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Cystic hygroma is a benign swelling of the neck among the pediatric population. It is a fluid-filled sac resulting from blockage in the lymphatic system and is commonly located in the cervical region and axilla.

A 12- year- old boy presented to the department of pediatrics. He was then referred to the care of both cardiothoracic and maxillofacial surgery teams. The patient had a painless swelling on the left side of his neck. The swelling started 4 months ago when it was noticed by the child’s parents, but it was too small. He was complaining of dyspnea during normal day exercises. Upon examination, the swelling was present over the region extending from carotid sheath to mediastinum on the left side passing behind the sternum. The swelling was soft on palpation, with poorly defined margins, non tender and when subjected to light test was brilliantly translucent. Fine needle aspiration cytology [FNAC] revealed that the mass contained clear yellow fluid in which no tumor cells were present and was diagnosed as cystic hygroma.

Magnetic resonance imaging (MRI) of the lesion showed a well-defined cystic lesion in the left upper anterior triangle of the neck deep to the sterno cleido mastoid muscle involving the carotid sheath and extending into mediastinum on the left side passing behind the sternum. When the lesion was found to be inseparable from the left side of the sternum total surgical excision of the lesion was planned together with the cardiothoracic team and open thoracotomy was done and the lesion was dissected from the mediastinum and the pleura up to the suprasternal notch. The lesion was adherent to the carotid sheath and was dissected from it through a midline neck incision by the maxillofacial surgery team. Following excision, the cyst was measured to be 20 cm in length. 6 months follow up with no recurrence evidence.

Source: https://www.sciencedirect.com/science/article/pii/S221026122030763X?dgcid=rss_sd_all
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