SPONTANEOUS RESOLUTION OF A LARGE NEONATAL ABDOMINAL LYMPHATIC MALFORMATION MANAGED CONSERVATIVELY: A CASE REPORT
DOI:
https://doi.org/10.67214/09mtby23Keywords:
conservative approach, lymphatic malformation, preterm neonateAbstract
Introduction: Abdominal lymphatic malformations are rare benign malformations of the lymphatic system, most commonly diagnosed during childhood, whereas prenatal and neonatal diagnosis are exceedingly rare. These lesions can enlarge and cause significant morbidity due to compression of adjacent organs. Therefore, surgical excision is traditionally considered the treatment of choice.
Objective: To present a case of a neonate with a large abdominal lymphatic malformation that was managed conservatively with a favorable outcome.
Case presentation: We present the case of a male moderate preterm neonate with apparent colonic dilatation on fetal ultrasonography, raising suspicion of intestinal atresia. After birth, the infant developed abdominal distension and respiratory distress. Radiological evaluation revealed a cystic lesion located in the left hemiabdomen and left retroperitoneal space, consistent with a large neonatal abdominal lymphatic malformation, measuring 55 × 65 × 133 mm at its maximum dimensions. A multidisciplinary board evaluated the risks of surgical intervention versus conservative observational management. At 16 months of age, complete spontaneous resolution of the lesion was documented.
Conclusion: This rare outcome suggests that not all abdominal lymphatic malformations in the neonatal period require surgical treatment. In carefully selected, clinically stable neonates, an initial strategy of watchful waiting supported by strict clinical and ultrasonographic surveillance is a safe alternative to immediate surgery or sclerotherapy. Establishing clear multidisciplinary intervention criteria remains essential to ensure patient safety during conservative observation.
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Copyright (c) 2026 Aleksandra Bogoevska (Author)
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