Lymphangioma Behind The Auricle

Lymphangiomas of the ear

Lymphangioma Behind The Auricle

Lymphangiomas are benign tumors of lymph vessels. It is one of the most common congenital cystic malformations seen in the head and neck region in the neonatal period. Malignant cancers can be transformed or spontaneous disappearance (regression) in lymphangiomas. Surgical excision or sclerosing agent injection can also be treated. The lenangioma behind the ear was surgically removed and the patient was followed-up without any problem.

General information about lymphangiomas 

Lymphangiomas are generally seen under two years of age, benign in nature affecting lymphatic ducts malformations. Most often from the head and neck region they originate. Although it is rare in adulthood cervical masses should be kept in mind in the differential diagnosis. Diagnosis is made through with history, physical examination findings and imaging methods. Lymphangiomas rarely seen in the lymphatic system congenital proliferation. Diagnosis often childhood years of age. It is very rare in adults. Head and The neck region is the most common place of origin. Head and neck lymphangiomas are often found in the neck, oral cavity mucosal surface and especially the tongue. In the treatment preferred main method is total excision.

Definition of lymphangioma

Lymphangiomas are congenital malformations that are thought to have been caused by congenital obstruction in the development of primordial lymph ducts. 75% of these lesions are located in the head and neck region. It is mostly found in infants or infants under two years of age. Although it was not expected to be seen in adulthood, the patient was 16 years old and had a cystic mass behind the ear. There are studies reporting that cystic lymphangioma can be detected secondary to trauma in adults. Swelling behind the ear in infants, is one of the conditions to be considered. Rarely, lymphoma, post-infectious lymphadenopathy, sebaceous cyst can cause a mass lesion behind the ear.

Diagnosis of lymphangiomas 

The definitive diagnosis of the disease is made histopathologically. Histopathological examination is often accompanied by lymphangiomatous tissue and lymphocyte assemblies, as well as multilobulated dilated lymph channels covered by a series of flat endothelial layers. Lymphangiomas are divided into three groups as capillary, cavernous and cystic.

Differential diagnosis of lymphangiomas 

Lipoma, dermoid cyst, branchial cyst, thyroglossal cyst in differential diagnosis and neck masses such as hemangioma must be considered. Therefore radiological examination may be required. Imaging methods; To confirm the structure of the lesion, differential diagnosis, mass boundaries and its relationship with surrounding tissues. useful in determining. Determining the size of the audience MRI is obtained from both USG and computed tomography. give more accurate information.

Treatment of lymphangiomas

Because of the high rate of recurrence in the treatment methods such as drainage and aspiration, these methods were not thought to provide effective and definitive treatment. In addition, studies reporting increased risk of infection in these methods are available in the literature. For the purpose of treatment, 5% dextrose, boiling water, sodium moruate and some sclerosing agents (bleomycin, etc.) were used. In these methods, scar formation, the possibility of damaging neighboring structures and distant (pulmonary fibrosis with bleomycin use) have been reported. However, intra-lesion injections should be considered as a second treatment modality in the masses that cannot be completely removed surgically. Radiotherapy can also be used for treatment. The definitive treatment of cystic lymphangioma is surgical excision. In adult patients, complete excision can be achieved due to the capsule structure of lymphangioma. However, complete removal of the lymphangioma in children is difficult. This is usually due to the thin wall of the mass in children and the involvement of surrounding tissues. Recurrence may occur in cases that are not completely removed. In the photograph presented in this article, there was no recurrence in the 3-year follow-up after complete surgical excision.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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