Spontaneous complete regression of a cervical macrocystic lymphatic malformation following infection in an infant: A case report

Lymphatic malformations most frequently involve the head and neck region, accounting for nearly two-thirds of all reported cases, and are often diagnosed in infancy or early childhood. Approximately half of the lesions are present at birth, while up to 90% become clinically evident before the age of two years. Clinically, these lesions typically present as soft, painless, compressible masses that may progressively enlarge and occasionally cause functional complications such as airway compression, dysphagia, or cosmetic deformity. Although lymphatic malformations are histologically benign, their clinical course can be unpredictable. Episodes of infection, hemorrhage, or sudden enlargement may occur and can significantly modify the presentation of the lesion. Imaging modalities such as ultrasonography, computed tomography, and magnetic resonance imaging are commonly used to confirm the diagnosis and evaluate the extent of the lesion and its relationship with adjacent structures. Management strategies include surgical excision, sclerotherapy with various agents such as bleomycin or OK-432, or a combination of both approaches depending on lesion size and location. Nevertheless, spontaneous regression of lymphatic malformations has occasionally been described in the literature and appears to occur in a small proportion of patients. In some cases, inflammatory or infectious episodes may induce endothelial damage and fibrosis of the cystic spaces, leading to a reduction in lesion size or even complete resolution. Herein, we report the case of a large congenital cervical macrocystic lymphatic malformation in an infant that underwent complete regression following a superinfection treated with antibiotic therapy alone.