Case report

This is a 35-year-old woman (G5; P4), with an unremarkable history. Her first ultrasound examination was done at 37 weeks of gestation. An isolated left abdominopelvic cystic lymphangioma was discovered (images 1A, 1B, 1C, 1D). No infiltrative growth was noted. The left kidney was slightly pushed away (images 1E, 1F). Fetal MRI was done at 39th week of pregnancy (images 2A, 2B, 2C, 2D).

The baby was delivered by Cesarean section due to macrosomia and risk of dystocia (birth weight 4500 g - image 3A). Postnatal clinical examination was normal and X-ray investigation was done (image 3B). Postnatal ultrasonography and MRI also confirmed the antenatal findings.

The baby underwent surgical operation and the tumor was removed. Histological examination confirmed the diagnosis of cystic lymphangioma.

Images 1A, 1B: 37 weeks of gestation; 2D ultrasonography. Transverse planes showing cystic abdominopelvic mass representing congenital lymphangioma.

Images 1C, 1D: 37 weeks of gestation; 2D ultrasonography. Transverse plane showing fetal kidneys (left image); and sagittal scans (right image) showing compressed left kidney by cystic mass of lymphangioma (left part of the right image) and normal right kidney (right part of the right image).

Images 1E, 1F: 37 weeks of gestation; 2D ultrasonography. Coronal plane showing left fetal kidney next to cystic mass representing lymphangioma (left image); and transverse plane through cystic mass of the lymphangioma (right image).

Images 2A, 2B: 37 weeks of gestation; MRI transverse images showing cystic mass of lymphangioma at the level of the left part of the abdominal cavity protruding to the left side.

Images 2C, 2D: 37 weeks of gestation; MRI coronal and nearly sagittal planes showing cystic mass representing lymphangioma at the level of the abdomen protruding to the left side.

Images 3A, 3B: Postnatal appearance of the baby (left); and X-ray image showing prominent mass at the left side of the abdomen.

Images 4: Postnatal MRI - transverse image showing cystic mass at the level of the left part of the abdominal cavity and protruding to the left side.