Lymphangioma

What is a lymphangioma?

A lymphangioma is an uncommon noncancerous fluid-filled bump under the skin (cyst) caused by overgrown lymph vessels. Lymph vessels (or channels) are responsible for moving lymphatic fluid and white blood cells through your tissues and bloodstream. If your child has a blockage in their lymph vessels, fluid collects at the blockage to create cysts.

Most lymphangiomas appear when your child is born. Most often, they form on the head and neck but can form anywhere on the body.

Who does a lymphangioma affect?

Lymphangiomas usually affect infants between birth and 5 years. The condition is most common among children diagnosed with genetic conditions including:

• Down syndrome.
• Noonan syndrome.
• Trisomy 13.
• Trisomy 18.
• Trisomy 21.
• Turner syndrome.

How common is lymphangioma?

Lymphangiomas are rare and account for only 4% of all vascular tumors (a tumor that forms from cells that make up blood vessels or lymph vessels) and 25% of all noncancerous vascular tumors in children in the United States.

What are the symptoms of lymphangioma?

Symptoms of lymphangioma are unique to each person diagnosed with the condition and vary based on the size (depth) and location of the cyst including:

• Cystic hygroma (cystic lymphangioma): A red to blue swollen, fluid-filled mass often found on the neck, groin or armpit.
• Cavernous lymphangioma: A red to blue swollen, rubbery mass often found on the tongue but can form anywhere on the body.
• Lymphangioma circumscriptum: A small group of clear to pink to red to brown or black pimple-sized, fluid-filled blisters found on the mouth, shoulders, neck, arms and legs.

All cysts, no matter the size, contain fluid. If an injury breaks open a cyst, clear fluid will leak out.

Lymphangiomas don't normally cause pain and should not be itchy. These cysts are almost always benign (noncancerous) and are rarely life-threatening. Life-threatening cases depend on the size and location of the cyst, especially if the cyst blocks a vital organ like your eyes, mouth or lungs and prevents your child from using their body as they should.

What causes lymphangioma?

The exact cause of lymphangiomas is unknown, but they happen as a result of your child’s lymphatic system not forming properly during fetal development.

Your body has a network of vessels, tissues and organs that carry lymphatic fluid, which contains white blood cells, through your bloodstream and tissues. This network is the lymphatic system and it regulates how much fluid is in your body to help your immune system function properly. Like a hose carrying water, your lymphatic system is constantly flowing.

Sometimes, the fluid in the lymph vessel backs up, similar to a kink in a hose. This kink creates a pool of lymph fluid to collect in front of the blockage. As a result, the pool of fluid appears as a liquid-filled bump on the skin (cyst).

How is lymphangioma diagnosed?

Depending on the size of the lymphangioma, a prenatal ultrasound can detect the cyst before birth. After your baby is born, your healthcare provider will examine the cyst. They might order an ultrasound or MRI to learn more about the size and what caused the growth.

If there are no lymphangiomas present when your child is born, the cysts could form between birth and 2 years of age, sometimes up to 5 years. Cysts become more noticeable with age.

How is lymphangioma treated?

After diagnosis, your child’s provider will identify treatment options unique to their cysts. Most of the time, lymphangiomas don’t need treatment since they are noncancerous.

Treatment might be necessary if the cyst is large and prevents your child from moving or it is blocking a vital organ. Your provider will work to remove the cyst by performing:

• Surgery.
• Laser therapy.
• Sclerotherapy.

Are there any complications of the treatment?

There is a high chance that the cyst could return after treatment because it is very difficult to locate and remove all affected lymphatic cells that caused the cyst to grow. Cysts that are close to the surface of the skin have a lower chance of returning because most cells are easy to remove. Other cysts are large and deep within the skin’s tissue. These cysts are difficult to remove and tend to grow back after treatment.

There is a high risk of infection after surgery that could complicate the healing process. Taking steps to prevent infection by cleaning and taking care of the surgical site leads to the best outcome.

How can I prevent lymphangioma?

You can’t prevent lymphangiomas from forming because they are the result of abnormal lymphatic system development that happened while your child was growing. In some cases, lymphangiomas form as a symptom of an underlying genetic condition. If you plan on becoming pregnant and want to understand your risk of having a child with a genetic condition, talk with your healthcare provider about genetic testing.

What can I expect if my child has a lymphangioma?

The majority of lymphangiomas are non-life-threatening and will not cause any health problems for your child. In rare cases, the location and size of the cyst can cause organs to not work effectively, especially if located on the chest, near the eyes or mouth.

As your child’s caretaker, monitor their lymphangioma. Reach out to their healthcare provider if you notice changes to the size, color or location of the cyst, or if the cyst prevents your child from moving normally.

How long does a lymphangioma last?

There is no cure for lymphangiomas and they often become more noticeable with age. Lymphangiomas rarely go away on their own, so treatment might be necessary for your child if their cyst is large or located on a part of their body that poses a threat to their health. If your child has small lymphangiomas, treatment isn’t necessary and their cyst is part of what makes them unique.

When should I see my healthcare provider?

Talk to your healthcare provider if your child’s lymphangioma:

• Changes in size or shape.
• Changes color.
• Feels warm to the touch.
• Becomes infected after surgery (leaks yellow or clear pus).
• Prevents your child from moving normally or using part of their body.

What questions should I ask my doctor?

• Does my child’s lymphangioma need to be removed?
• What are the odds that my child’s lymphangioma will return after surgery?
• What should I do if my child injures their lymphangioma?

A note from Cleveland Clinic

Lymphangiomas are noncancerous cysts that form on your child’s body and usually won’t pose a threat to their overall health. Make sure you monitor your child’s lymphangioma for changes and contact your healthcare provider if anything unusual happens. Sometimes lymphangiomas are the result of genetic changes, so talk with your provider about genetic testing to understand your risk of having a child with a genetic condition.