Philippine Journal of Surgical Specialties Vol. 74, No. 2, July-December, 2019, pp 44-49

Adult-Onset Cystic Hygroma in the Axilla in a 44-year old Female: A Case Report

Author(s): Stephen Sixto Siguan, MD, FPSGS, FPCS, FACS and Mary Nicole A. Velez, MD


This is a case of a 44- year old female presenting with an 18cm x 17cm soft, movable, non-tender mass at the right axilla extending to the lateral aspect of the right breast. Computerized tomographic scan of the chest revealed a lobulated, multi-septated hypodense mass. The patient underwent excision of the right axillary mass and final histopathology revealed cystic lymphangioma. Adult-onset cystic hygroma of the axilla is a rare case, with less than 10 studies documented in PubMed. Total surgical excision remains to be its primary treatment.

Cystic Hygroma, also known as lymphangioma, is a benign congenital malformation of the lymphatic system that is caused by an obstruction of communication between the lymphatic and venous systems. The lack of communication results to lymphatic accumulation in the areas of major lymphatic channels, especially at areas with less resistance, including the cervical and the axillary regions. Eighty percent of cystic hygromas occur in the neck, usually at the posterior cervical triangle. The axilla, superior mediastinum, mesentery, retroperitoneal region, pelvis, and lower limbs are also areas of occurrence. Cystic hygroma is typically found in children and usually occurring in the cervico-facial region. Its diagnosis is uncommon in adults and literature review has shown rare data on adult- onset cystic hygroma in the axilla.5,6,8 The main objective of this paper was to present a rare case of adult-onset cystic hygroma of the axilla, and to report known data of the case based on published medical literature, reviewing its clinical presentation, diagnosis, pathologic findings and management.

Key words: Adult-onset cystic hygroma, cystic hygroma, lymphangioma, axilla