Figure 1.146. Cystic hygroma of the right side of the neck with involvement of the mucous membranes. Cystic hygroma is a benign loculated cystic mass which is soft, diffuse, impressible, and translucent due to accumulation of fluid in the lymphatics. The commonest sites are in the neck (hygroma colli), axilla, and upper arm. Rarely they are seen in the groin or popliteal fossa. They do not resolve spontaneously. Surgical treatment may be complicated and recurrences are uncommon following complete removal.

Figure 1.147. Transillumination of the cystic hygroma in the same infant as in Figure 1.146. Note the extent of involvement of the neck and mouth.

Figure 1.148. This infant with a massive diffuse lymphangioma (elephantiasis congenita angi-omatosis or elephantiasis lym-phangiectatica) had severely compromised respiration from the tumor and required trach-eostomy. Note the large area of nevus present superficially over the anterior part of the chest. Biopsy diagnosis was a hemangi-olymphoma. Note the redness of the area which was related to secondary infection, a common complication.

Figure 1.149. In another infant with elephantiasis congenita angiomatosis, note the massive involvement of the right lower extremity. Diffuse angiomas (elephantiasis lymphangiectatica) are large, ill-defined cystic dilatations involving the skin, subcutaneous tissue, muscles, and mucous membrane. They may involve the trunk, extremities, and large areas of the face, lips, or tongue. There is marked enlargement of the affected areas as a result of invasion by the cystic lymphatics. The areas may have a red or purplish color because of the presence in the vesicles of blood mixed with lymph.

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