Unusual Presentation of Giant Omental Cystic Lymphangioma Mimicking Hemorrhagic Ascites in a Child
Cystic lymphangioma is a benign, mesodermal, congenital tumor that stems from abnormal lymphatic tissue development. Complications from cystic lymphangioma include acute inflammatory episodes, infection, and intracystic hemorrhage (1). Microscopically, the cyst wall consists of a single layer of flattened epithelium with tissue spaces that may or may not contain blood-filled capillaries. The poorly supported blood vessels in cystic lymphangiomas may bleed and produce enlargement and discoloration of the cyst (2). The giant lesion and its blood-stained content can lead to difficulty distinguishing this lesion from hemorrhagic ascites (3). Bloody ascites during childhood is extremely rare, caused by only a limited number of disorders, including peritoneal tuberculosis, dengue fever, and malignancies.