Cystic hygroma/lymphangioma: A rational approach to management

Objective: To outline a rational approach to the management of cystic hygro ma based on the authors' experience, the natural history of the disease, an d the results of surgical treatment. Study Design and Methods: A retrospect ive review of all patients with the diagnosis of lymphangioma or cystic hyg roma from 1958 to 2000 was performed. Results: Seventy-four patients were i dentified with 46 cases confined to the cervicofacial region. Surgical exci sion was performed on 60 of the 74 cases involving all regions of the body and 34 of the 46 patients with head and neck lesions. The location of the m alformation is the most important determinate for surgical success. While s urgical excision was the main treatment modality, 11 of 12 untreated patien ts were noted to improve, with 8 patients showing complete resolution. Conc lusions: In the treatment of lymphangiomas, the physician should be experie nced in the management of such lesions, be aware of spontaneous resolution, and recognize the limitations and potential harm of surgery in certain ins tances.