Rare lymphatic malformation in an extreme premature infant: question

• Main Authors: Veronica Mugarab Samedi (Author), Adel Elsharkawy (Author)
• Format: Book
• Published: Hygeia Press di Corridori Marinella, 2017-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2281-0692; 10.7363/060209
• Keywords: lymphatic malformation; cystic lymphangioma; extreme prematurity; congenital mass; Medicine; R; Pediatrics; RJ1-570
• Source: Journal of Pediatric and Neonatal Individualized Medicine, Vol 6, Iss 2, Pp e060209-e060209 (2017)

Our patient was born to a healthy 35-year-old Asian mother. The pregnancy was uneventful until 25 weeks of gestational age (GA), when she had preterm prolonged rupture of membranes (PPROM). Ultrasound at that point showed a new finding (confirmed by MRI) of 4.7 x 4.1 cm heterogenous cystic skin-covered mass with areas of echogenicity on the posterior aspect of the fetus with blood flow to the mass and minimal vascularity overall. The male infant was delivered at 26 + 4 weeks by emergency caesarian section for fetal distress with birth weight of 720 grams. A significant finding was a massive swelling over the upper back with a firm central mass. Total size of swelling was 10.2 x 12.2 cm, central cystic mass was smaller (5.0 x 4.2 cm), firm in consistency, slightly mobile, non-pulsatile, non-compressible and non-translucent. Examination of mass did not cause changes in vital signs, thus the mass was considered as a painless malformation. • What is your diagnosis? • Which further investigations would you suggest? • Which subspecialties need to be involved in the management of this case?