Giant Prenatally Diagnosed Cervicofacial Cystic Lymphangioma in a Term Neonate: Case Report and Literature Review

Abstract

Cystic lymphangiomas are rare congenital malformations of the lymphatic system, most commonly affecting the cervicofacial region. Advances in prenatal imaging have improved antenatal detection, facilitating multidisciplinary coordination in perinatal care. We report a term male neonate with a giant cervicofacial cystic lymphangioma diagnosed antenatally in the third trimester. Clinical examination revealed a large, transilluminable mass without immediate airway compromise. CT angiography demonstrated a multiloculated cystic lesion extending into the parapharyngeal and mediastinal spaces, closely related to major neurovascular structures. Complete surgical excision was performed during the neonatal period, with preservation of vital anatomy. Histopathology confirmed a benign venolymphatic malformation. Optimal management of cervicofacial lymphangiomas relies on early recognition, precise imaging assessment, and coordinated multidisciplinary care. Surgical excision is the mainstay of therapy, complemented by adjuvant modalities such as sclerotherapy, laser therapy, or pharmacological agents when indicated, and continuous surveillance is mandatory to prevent recurrence.