Rare Cystic Hygroma of the Axilla and Breast in Adults, Case Report, Long-Term Follow-Up and Literature Review: An Experience from Saudi Arabia

Abstract

Introduction

Cystic hygroma (CH) in adults is a rare condition. Most CH cases are diagnosed at birth or during the first two years of life. Head and neck are the most common sites. There is scanty information about the natural history and follow-up of adult patients with axillary and breast CH. Hence, we present this case to shed some light on the natural history, complications, and a new suggested modality of treatment to deal with the complications.

Case Presentation

We report a case of a 39-year-old female who presented after ten years of excision of the right axillary CH with massive breast edema and recurrence of cysts in the ipsilateral breast and axilla. The insertion treated the edema of a breast-peritoneal shunt.

Discussion

The procedure was performed by inserting a normal V-P shunt catheter without a reservoir through a small incision in the inframammary fold toward the breast and another tiny incision at 10 of the clock in the right breast for fixation in the breast parenchyma. A catheter was inserted through a small incision on the right lumbar spine without intraperitoneal fixation after the catheter was inserted subcutaneously.

Conclusion

This case report shows that adult CH can reoccur. To our knowledge, this is the second case of CH concomitantly involving the breast and axilla. The shunt of the edematous fluid to the peritoneal cavity can give hope for intractable breast edema treatment.

Keywords:

• cystic hygroma
• adult
• case report

Ethical Approval

Ethical approval was issued by Research Ethics Local Committee on 21/05/2020 (Ref No: UBCOM.RELOC)/H-06-BH-087.

Consent

Written informed consent was obtained from the patient to publish this case report and accompanying images. On request, a copy of the written permission is available for review by the Editor-in-Chief of this journal.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, case report and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work. All authors contributed to the case report and management, have agreed on the journal and gave final approval of the version to be published. Al Ameer and Soha; data acquisition, manuscript preparation; AlAmeer, editing, and final approval; Nidal and Miskeen.

Disclosure

The authors report no conflicts of interest related to this article.

Additional information

Funding

The authors declare that this study had no funding resources. There is no sponsor for this study. The author covers all expenses.