PDF(Pubmed)
Abstract：
UNASSIGNED: Lymphatic malformation (LM), most commonly present in the neck area, is benign vascular malformations of the lymphatic system. In an infant, however, LM poses a high risk of adverse outcomes.
UNASSIGNED: We present a case with a giant fetal LM. Through ultrasonography, at 23+ weeks of gestation, a septate cystic mass 7.2×6.5×6.3 cm in size was found on the right side of the fetus\'s neck. After extensive counseling by the multidisciplinary team, the parents chose to continue the pregnancy. Severe fetal tracheal compression was observed at 29 weeks by magnetic resonance imaging (MRI). At 31 weeks and 5 days, owing to suspected fetal distress, an emergency cesarean section was performed and a male baby weighing 1720 g was delivered. The mass was 10×16×8 cm in size and ex utero intrapartum treatment (EXIT) was implemented. Due to progressive growth of the mass secondary to intralesional bleeding, an intralesional injection of bleomycin was administered three days later. This injection was repeated at the age of 1 month and 8 days. The baby was followed up and, by a year after his birth, LM had disappeared. The baby has since been in good health.
UNASSIGNED: Accurate prenatal diagnosis and regular monitoring of a fetus with LM may improve prognosis. It is essential to have a trained multidisciplinary team to evaluate the condition of the fetus and the neonate and to provide treatment based on the evaluation. Our experience with intralesional bleomycin injection for the treatment of a giant fetal neck LM in a preterm infant had a favorable outcome. Long-term follow-up by a multidisciplinary team is needed in such cases.
UNASSIGNED: We present a case with a giant fetal LM. Through ultrasonography, at 23+ weeks of gestation, a septate cystic mass 7.2×6.5×6.3 cm in size was found on the right side of the fetus\'s neck. After extensive counseling by the multidisciplinary team, the parents chose to continue the pregnancy. Severe fetal tracheal compression was observed at 29 weeks by magnetic resonance imaging (MRI). At 31 weeks and 5 days, owing to suspected fetal distress, an emergency cesarean section was performed and a male baby weighing 1720 g was delivered. The mass was 10×16×8 cm in size and ex utero intrapartum treatment (EXIT) was implemented. Due to progressive growth of the mass secondary to intralesional bleeding, an intralesional injection of bleomycin was administered three days later. This injection was repeated at the age of 1 month and 8 days. The baby was followed up and, by a year after his birth, LM had disappeared. The baby has since been in good health.
UNASSIGNED: Accurate prenatal diagnosis and regular monitoring of a fetus with LM may improve prognosis. It is essential to have a trained multidisciplinary team to evaluate the condition of the fetus and the neonate and to provide treatment based on the evaluation. Our experience with intralesional bleomycin injection for the treatment of a giant fetal neck LM in a preterm infant had a favorable outcome. Long-term follow-up by a multidisciplinary team is needed in such cases.
摘要：
■淋巴畸形（LM），最常见于颈部，是淋巴系统的良性血管畸形.在一个婴儿,然而,LM造成不良后果的高风险。
■我们介绍了一个巨大胎儿LM的病例。通过超声检查,在妊娠23周以上，在胎儿颈部右侧发现一个大小为7.2×6.5×6.3厘米的纵隔囊性肿块。经过多学科团队的广泛咨询，父母选择继续怀孕。在29周时通过磁共振成像（MRI）观察到严重的胎儿气管压迫。在31周零5天，由于疑似胎儿窘迫,实施了紧急剖宫产术,分娩了1名体重1720g的男婴.肿块大小为10×16×8cm，实施了子宫外产时治疗（EXIT）。由于病灶内出血继发的肿块进行性增长，三天后进行博莱霉素病灶内注射.在1个月零8天的年龄重复该注射。婴儿被追踪，在他出生一年后,LM消失了。此后，婴儿一直身体健康。
■对LM胎儿进行准确的产前诊断和定期监测可以改善预后。必须有一个训练有素的多学科团队来评估胎儿和新生儿的状况，并根据评估提供治疗。我们在早产儿中进行病灶内注射博来霉素治疗巨大胎儿颈部LM的经验取得了良好的结果。在这种情况下，需要多学科小组的长期随访。
■我们介绍了一个巨大胎儿LM的病例。通过超声检查,在妊娠23周以上，在胎儿颈部右侧发现一个大小为7.2×6.5×6.3厘米的纵隔囊性肿块。经过多学科团队的广泛咨询，父母选择继续怀孕。在29周时通过磁共振成像（MRI）观察到严重的胎儿气管压迫。在31周零5天，由于疑似胎儿窘迫,实施了紧急剖宫产术,分娩了1名体重1720g的男婴.肿块大小为10×16×8cm，实施了子宫外产时治疗（EXIT）。由于病灶内出血继发的肿块进行性增长，三天后进行博莱霉素病灶内注射.在1个月零8天的年龄重复该注射。婴儿被追踪，在他出生一年后,LM消失了。此后，婴儿一直身体健康。
■对LM胎儿进行准确的产前诊断和定期监测可以改善预后。必须有一个训练有素的多学科团队来评估胎儿和新生儿的状况，并根据评估提供治疗。我们在早产儿中进行病灶内注射博来霉素治疗巨大胎儿颈部LM的经验取得了良好的结果。在这种情况下，需要多学科小组的长期随访。
