Case Report
Cystic hygroma and potential airway obstruction in a newborn: a case report and review of the literature
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* Corresponding author: Sulaiman Sannoh fanta_sannoh@yahoo.com
1 Division of Neonatology, Children's Regional Hospital, Cooper University Hospital, Camden, New Jersey, USA
2 Division of Newborn Medicine, Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York, USA
3 Division of Otolaryngology, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA
Cases Journal 2009, 2:48 doi:10.1186/1757-1626-2-48
Published: 13 January 2009Abstract
Background
Cervical cystic hygroma is a benign congenital malformation of the lymphatic system. Incidence of cystic hygroma is 1/6000 live births. We present a case of right neck mass with potential respiratory compromise in a newborn.
Case presentation
The patient was a full term baby girl with an incidental finding of right neck mass which was described on ultrasound and magnetic resonance imaging as a cystic lesion in the nasopharynx and right neck which inferiorly followed the course of the right carotid artery, consistent with cystic hygroma. She started with respiratory compromise, and a follow-up magnetic resonance imaging showed increased size of the cystic hygroma. Dexamethasone was started to reduce fluid build up in the mass. When the cystic hygroma was found to be inseparable from the right half of the thyroid gland, the otolaryngologist performed hemithyroidectomy.
Conclusion
The patient had neuropraxia involving the marginal mandibular branch of the facial nerve, which was expected to correct with time. Large cervical cystic hygromas may surround or displace neurovascular structures making their identification quite challenging intraoperatively. A team of experienced surgeons will help to ensure a successful surgical outcome.