VP20.12 : Lymphangioma : fetal neck mass, delivery of pregnancy through EXIT technique – case report, University Hospital San Ignacio (HUSI)

Q1Lymphangioma is a rare type of benign tumour, caused by a lack of development of the lymphatic's system components. This malformation is an accumulation of fluid mainly located in the posterolateral region of the neck in 75% of cases, followed by armpit 20%, mediastinum 1%, abdominal organs, mesenteric retroperitoneal in 2–3% & bone, lower limbs in 2%. This develops in the second and third trimester. It could be aggressive due to the infiltration in adjacent tissues or closer organs, additionally, it could be associated with chromosomal abnormalities or other malformations, basically, the prognosis depends weather it is present or not. In isolated forms, these tumours have a good prognosis. In cases where the malformation is found on the neck in the first trimester, the assessment, behaviour, name, management and etiology could be different and it is called increased NT. The prenatal management includes serial ultrasound in maternal-fetal unit, karyotyping, MRI to see the level of infiltration and the associated airway obstruction, and multidisciplinary team experienced in airways management. In cases of cervical lymphangiomas, the gestation delivery should be done by a Caesarean section (CS) with an EXIT technique in order to guarantee the fetal airway before separation of the maternal-fetal circulation. it is imperative to set up the procedure through a multidisciplinary team meeting, in order to assign each of the roles in surgery and to know the additional materials or procedures in accordance with the fetal airway compromise. In this case the diagnosis was confirmed by maternal medicine team as a cervical lymphangioma in the HUSI in Bogotá through US performed on the 34.5 week. Additionally, we used an MRI to assess the fetal airway and after words we booked meetings with an interdisciplinary team with the objective of planning the procedures and materials required during the delivery through a CS with an EXIT technique, following the institutional protocols.Revista Internacional - Indexad