Giant fetal lymphangioma with non-immune hydrops fetalis
Keywords:Fetal, Giant, Hydrops fetalis, Lymphangioma, Septate
Fetal lymphangioma is one of the rarest congenital malformation occuring in the newborn. We are reporting a giant fetal lymphangioma which may be the largest one so far reported in medical literature and its association with non immune hydrops fetalis. A late preterm 35+3 weeks gestation female neonate with birth weight of 3.8 kg was delivered via emergency caesarean section, for prevention of birth injuries in view of large for gestation. Baby had weak cry at birth. On examination a giant cystic mass extending from right hemithorax to right anterolateral abdominal wall measuring 25×12.5×9 cm was present. Systemic examination revealed respiratory distress and ascites. Neonate was admitted in NICU and started on supportive measures, despite which went into cardio respiratory arrest at second hour of life and revived with Cardiopulmonary resuscitation. Baby had second cardiopulmonary arrest at 9 hours of life and couldn’t be revived. Antenatal ultrasound showed massive ascites, bilateral pleural effusion with cardiomegaly and multiseptated cystic swelling over right chest wall. Based on clinical and antenatal findings we made a diagnosis of Giant fetal lymphangioma with non-immune hydrops fetalis. Giant fetal lymphangioma is an antenatal diagnosis. Its association with non-immune hydrops fetalis is a bad prognostic indicator with high mortality.
Lu D, Wang Y, Zeng W, Peng B. Giant fetal lymphangioma at chestwall and prognosis: Case report and literature review. Taiwanese J Obstet Gynecol. 2015;54:62-5.
Kamble V, Bhatia T, Patil S. Cystic hygroma with hydrops fetalis: a rare case report. Int J Reprod Contracept Obstet Gynecol. 2014;3(3):847-50.
Ersoy AO, Oztas E, Saridogan E, Ozler S, Danisman N. An unusual origin of fetal lymphangioma filling right axilla. J Clin Diagn Res. 2016;10(3):QD09-11.
Gallagher PG, Mahoney MJ,Gosche JR. Cystic hygroma in the fetus and newborn. Semin Perinatol. 1999;23(4):341-56.
Kenneth M, Lopez S. Non immune hydrops fetalis. In: Eric CE, Anne R. Hansen CR. Stark MAR, eds. Cloherty and Stark’s Manual of Neonatal Care. 8th ed. Netherlands: Wolters Kluwer; 2017:52-63.
Gedikbasi A, Gul A, Sargin A, Ceylan Y. Cystic hygroma and lymphangioma: associated findings,perinatal outcomeand prognostic factors in live-born infants. Arch Gynecol Obstet. 2007;276:491-8.
Ali MK, Abdelbadee AY, Shazly SA, Othman ER. Hydrops fetalis with cystic hygroma: A case report. Middle East Fertil Soc J. 2012;17:134-5.
Fouedjio JH, Fouelifack FY, Ebune LJ. Antenatal diagnosis and management of nuchal cystic hygroma:A case report in the Yaounde central maternity, Cameroon. Clin Mother Child Health. 2011;8:1-3.
Ravikanth R, Prasannan R. Hydrops fetalis with septated cystic hygroma. Apollo Med. 2019;16:47-9.