Two children with lymphangioma circumscriptum (LC), a rare cutaneous l
ymphangioma, are described. One was diagnosed antenatally as having a
right axillary cystic hygroma; in addition, postnatally LC was noted o
n the right forearm. A few years later a mediastinal lymphangioma was
diagnosed, This combination of LC associated with additional malformat
ions of the lymphatic system has not been reported previously, and may
point to a generalized developmental disorder of the lymphatic system
. The pathophysiology of the lesion is discussed with a review of the
pertinent literature. It appears that LC primarily affects the subcuta
neous tissue in the form of cystic dilatation of lymphatic channels wi
thout systemic lymphatic communication. The skin lesions are probably
secondary to the increased intraluminal pressure. The typical clinical
appearance is manifested by multiple skin vesicles and lymphorrhoea.
The main treatment modality is surgical excision. Recurrences are not
unusual and require re-excision.