eMedicine Specialties > Dermatology > Diseases of the Vessels

Lymphangioma: Follow-up

Author: Geover Fernandez, MD, FAAD, Staff Physician, Department of Dermatology, University of Medicine and Dentistry New Jersey, New Jersey Medical School
Coauthor(s): Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Contributor Information and Disclosures

Updated: Mar 19, 2007

Follow-up

Further Inpatient Care

  • In the case of lymphangioma circumscriptum, severe recurrent cellulitis may warrant inpatient care at times, especially in patients who are immunocompromised.

Further Outpatient Care

  • Patients should be monitored and treated for cellulitis, especially those with ruptured vesicles, which provide a portal of entry for infection.
  • Regular skin examination should be included in the follow-up treatment to evaluate recurrence and the response to treatment.

Complications

  • Lymphangioma circumscriptum may occur.
    • This condition is associated with minor bleeding, recurrent cellulitis, and lymph fluid leakage.
    • Two cases of lymphangiosarcoma arising from lymphangioma circumscriptum have been reported. However, in both of the patients, the preexisting lesion was exposed to extensive x-ray therapy. Therefore, radiation therapy should be avoided in lymphangiomas.
  • In cystic hygroma, large cysts can cause dysphagia, respiratory problems, and serious infection if they involve the neck.

Prognosis

  • Lymphangiomas are benign hamartomatous malformations instead of true neoplasms.
  • The prognosis is excellent.

Patient Education

  • Patients should receive reassurance.
  • Lymphangiomas represent benign lymphatic malformations and not premalignant lesions.
  • Patients should be aware of the risk of recurrence.

Miscellaneous

Medicolegal Pitfalls

  • Failure to evaluate for congenital disorders, such as Turner syndrome and Down syndrome, in patients with cystic hygroma

Special Concerns

  • Cystic hygroma can be associated with the following congenital disorders:
    • Turner syndrome
    • Chromosomal aneuploidy
    • Hydrops fetalis
    • Down syndrome and other trisomy disorders
    • Fetal alcohol syndrome
    • Noonan syndrome
    • Several other congenital syndromes
  • Patients with cystic hygroma should undergo cytogenetic analysis for chromosomal aneuploidy.
  • Parents should receive genetic counseling because aneuploidic conditions can recur in subsequent pregnancies.
 


More on Lymphangioma

Overview: Lymphangioma
Differential Diagnoses & Workup: Lymphangioma
Treatment & Medication: Lymphangioma
Follow-up: Lymphangioma
Multimedia: Lymphangioma
References
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References

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  4. Ahn SJ, Chang SE, Choi JH, Moon KC, Koh JK, Kim DY. A case of unresectable lymphangioma circumscriptum of the vulva successfully treated with OK-432 in childhood. J Am Acad Dermatol. Nov 2006;55(5 Suppl):S106-7. [Medline].

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Further Reading

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Keywords

cutaneous lymphangioma, lymphangioma circumscriptum, cavernous lymphangioma, cystic hygroma, abnormal lymph vessel, lymph vessel

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Contributor Information and Disclosures

Author

Geover Fernandez, MD, FAAD, Staff Physician, Department of Dermatology, University of Medicine and Dentistry New Jersey, New Jersey Medical School
Geover Fernandez, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and American Society for MOHS Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi
Disclosure: Nothing to disclose.

Medical Editor

Carrie L Kovarik, MD, Assistant Professor, Department of Dermatology and Dermatopathology, University of Pennsylvania School of Medicine
Carrie L Kovarik, MD is a member of the following medical societies: Alpha Omega Alpha
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Director, Division of Dermatology, Scott and White Clinic; Director Dermatology Residency Training Program, Scott and White Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Jeffrey J Miller, MD, Associate Professor, Department of Dermatology, Penn State University, Milton S Hershey Medical Center
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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