Cystic cervicofacial lymphangioma in children in Gabon

To review the etiopathogenesis, diagnosis, and the role of surgery in the management of childhood cystic cervicofacial lymphangioma in Gabon. Our retrospective study concerned 16 cases of childhood cystic cervicofacial lymphangioma treated surgically between 1990 and 2004. The sample included ten girls and six boys whose average age was 30.2 months. The cystic lymphangioma was seen at birth in seven cases. It was discovered before 2 years in eight cases and after 2 years in eight cases. Two of these latter eight cases were a recurrence after previous surgery. The tumor was localized in the cervical are in ten cases, the jugal area in three cases, one of which was extended to the parotidis, the submandibular area in two cases, and the lower labial area in one case. The surgical indication was based on the clinical examination in six cases and on imaging in ten cases. The resection was considered complete in 14 cases and incomplete in two cases. In two cases, the resection was difficult, because the lymphangioma adhered to the internal jugular vein and rolled the higher laryngeal nerve and the carotid junction. The early complications were lymphoedema associated with facial paralysis (one case) and respiratory distress (one case), hematoma associated with facial paralysis (one case), lymphorrhea (one case), and a paralysis of the chin branch of the facial nerve (one case). The functional and aesthetic after-effects were marked by the persistence of facial paralysis and the existence of jugal bud flesh. The jugal (one case) and labial (one case) recurrence were discovered within 6 and 9 months after the surgery. In these two cases, there were capillary lymphangiomas. None of the patients died. Cystic cervicofacial lymphangioma is a particular aspect of surgical pathology in children in Africa. Despite the advent of sclerosing products, surgery remains the treatment of choice in this context.