Rare Case Report Describes Giant Omental Bursa Cystic Lymphangioma During Pregnancy
Clinicians recently identified an exceptionally rare case of a giant cystic lymphangioma arising from the omental bursa in a pregnant patient, marking a significant diagnostic challenge due to the lesion's uncommon adult presentation and deep abdominal location. These benign yet expansive malformations of the lymphatic system are rarely seen in obstetric practice, particularly when they reach a size that mimics other massive intra-abdominal pathologies and requires complex surgical intervention.
These findings are published in the Indian Journal of Surgery by Venugopal H.G. and co-author Lokesh Kalki Boddeda in April 2026.
The case serves as a crucial reminder for surgeons and obstetricians to include cystic lymphangioma in the differential diagnosis for large abdominal cystic masses during pregnancy. Early identification prevents vascular compression, while precise surgical planning ensures complete lesion removal without compromising adjacent organs.
A 31-year-old patient at 20 weeks gestation presented with progressive abdominal distension, prompting the use of routine obstetric ultrasonography (USG) and contrast-enhanced computed tomography (CECT) to identify a 25 × 20 cm multiloculated mass. After a medical termination of pregnancy (MTP), the diagnosis of cystic lymphangioma was confirmed by histopathological examination (HPE) following an exploratory laparotomy to excise the lesion en-bloc, which ultimately resulted in a successful recovery with all major abdominal structures preserved.
Cystic lymphangiomas are rare benign lymphatic malformations that can present in adults as deep, slow-growing abdominal masses. Since these lesions displace rather than invade major vessels and viscera, precise surgical dissection of their thin-walled, multiloculated compartments is required for complete en-bloc removal.
Clinical Relevance and Potential Implementations
The case report underscores the clinical importance of utilizing advanced imaging modalities to differentiate these rare lymphatic lesions from other common abdominal cysts, thereby facilitating informed surgical planning and improving patient safety during pregnancy-related health complications. It establishes a successful management framework for deep-seated omental bursa lesions, suggesting that excellent clinical outcomes are achievable through careful anatomical dissection and the early recognition of these highly unusual presentations.
Reference
Venugopal, H. G., & Boddeda, L. K. (2026). Giant cystic lymphangioma of the omental bursa in pregnancy: A rare case report. Indian Journal of Surgery. Published April 9, 2026.
