Cystic Hygroma

Question 1

What is a cystic hygroma

Answer 1

A congenital cystic lymphatic malformation found in the posterior triangle of the neck. Most present at birth or before the age of 2

Question 2

What are the features of a cystic hygroma

Answer 2

Lobulated cystic swelling

Soft and fluctuant

Compressible

‘Brilliantly transilluminable’

If large, may extend deeply beneath the sternocleidomastoid muscle into the retropharyngeal space

Question 3

What are the complications of a cystic hygroma

Answer 3

Cosmetic

Complications before delivery:

• May obstruct delivery

Complications after delivery:

• Respiratory obstruction
• Obstruction of swallowing

Question 4

What investigations would help diagnose a cystic hygroma

Answer 4

CXR - to map the caudal extent of the cystic hygroma

CT/MRI scanning - especially if complex

Question 5

How would you treat a cystic hygroma

Answer 5

Non-surgical:

• Aspiration

Surgical:

• Excision