Mediastinal cystic lymphangiomas : a single institution experience

Introduction : Mediastinal cystic lymphangiomas (MCL) are benign malformative lesions originating in lymphatic vessels of the mediastinum. This localization is extremely rare. They often pose a problem of differential diagnosis and management. Material and methods: We conducted a retrospective study including patients managed for mediastinal cystic lymphangiomas in the thoracic surgery department, Abderrahmen mami hospital, Ariana between 2000 and 2022. <bold>Results:</bold> There were 6 men and 8 women, with an average age of 29.3 years old. It was discovered before the age of two years in 4 cases, and after the age of 25 years in 8 cases. Symptoms included chest pain (7 cases), cough (6 cases) and dyspnoea (2 cases). Chest X-ray showed an enlarged mediastinum in 10 cases and was normal in 4 cases. The diagnosis was suspected on CT scann in 12 cases, the other two patients underwent biopsy by mediastinoscopiy, confirming the diagnosis. Localization of the MCL was in anterior mediastinum in 7 cases and in middle mediastinum in 7 cases. All of our patients were operated on. Surgical approches were posterolateral thoracotomy in 4 cases, sternotomy in 3 cases, cervicotomy in 2 cases and minimally invasive approaches in 5 cases. Intact cyst resection was performed in 10 cases. Post operative course was uneventful. Conclusion : Mediastinal cystic lymphangiomas are very rare benign tumors. Medical imaging allows us to suspect the diagnosis, which is anatomopathological. Surgery remains the first line treatment of choice.