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Objective: Congenital lymphangiomas are rare but account for one of the most common fetal tumors. Current imaging modalities including ultrasonography and fetal magnetic resonance image (MRI) facilitate antenatal diagnosis, but antenatal counseling about fetal lymphangioma may be still difficult due to variable clinical presentation such as diversity of location. The objective of this study was to review clinical outcome of congenital lymphangioma prenatally diagnosed and to provide proper information on antenatal counseling.
Methods: We reviewed the medical records of women and their live neonates whose diagnosis were described as congenital lymphangioma in their delivery notes from January 2005 to December 2011 in Samsung Medical Center (n=14). Pregnancy outcome, antenatal surveillance findings such as ultrasonography, fetal MRI, and amniocentesis, and neonatal outcomes including postnatal image, method and timing of treatment were investigated. We also examined the treatment outcome.
Results: The median gestational age at diagnosis and delivery was 26.3 weeks (range: 22.0-36.1) and 38.5 weeks (range: 35.0-41.0), respectively. Amniocentesis was done in four cases with congenital lymphangiomas located in lateroposterior neck and the result showed normal karyotype in all cases. Eight neonates were delivered vaginally and six neonates by cesarean section. Among 14 cases, one congenital lymphangioma was found to be disappeared in postnatal examination. The main location of prenatally diagnosed congenital lymphangiomas was neck (78.6%, 11/14) and the most common treatment modality used was OK-432 injection (61.5%, 8/13). Notably, during postnatal follow up period, 23.1% (3/13) of congenital lymphangiomas were resolved and 61.5% (8/13) were decreased in size. Rehabilitation treatment has been currently underway in two cases with congenital lymphangiomas located in anterior neck. Namely, with median 19.5 month postnatal follow up, most of congenital lymphangiomas showed satisfactory neonatal outcome but multidisciplinary approaches were required in cases with anterior neck.
Conclusion: In this study, we could provide proper information on antenatal counseling about congenital lymphangioma.