Giant mesenteric lymphangioma

Abstract Mesenteric lymphagiomas are cystic lesions and therefore called mesenteric cysts. They are benign tumors of the lymphatic system, with low incidence in the general population, and even lower in the pediatric population. The clinical presentation is quite variable raging from incidentally found or even as a cause of acute abdomen. This study reports the rare case of giant mesenteric lymphangioma in a child with complaints of recurrent abdominal pain, referred to the pediatric hepatology service for ascites investigation, identified on physical examination and confirmed on abdominal ultrasound. On admission, a abdominal computed tomography was requested, revealing a massive cystic formation, which occupied the lower two-thirds of the abdomen. The patient underwent exploratory laparotomy, upon which a large mesenteric cyst in the jejunum was visualized. The histological analysis of the cyst revealed findings are compatible with lymphangioma. After surgical procedure, the patient maintained a good clinical evolution, with complete resolution of abdominal pain. Although rare, mesenteric lymphangioma should be included in the differential diagnosis list of gastrointestinal symptoms and recurrent abdominal pain in children. In addition, there may be initial confusion with ascites when there are large-volume tumors.