What is a cystic hygroma?
A cystic hygroma is also known as a lymphangioma. It is a painless, benign cyst that looks like a fluid-filled sac.
It can develop on your baby during pregnancy and is detectable by an ultrasound. In some cases, it may not show up until after your baby is born. At that point, it will be a noticeable bump or bulge under their skin.
While most cystic hygromas are located on the neck or under the arm, they can be found anywhere on the body. Prompt treatment is crucial. If left untreated, a cystic hygroma can grow over time. Characteristics that you might notice about the cyst include:
- A blue tint in the skin on top
- Soft texture
- Size ranging from a grape to a grapefruit
If the hygroma appears during pregnancy, it could create an excess amount of fluid in the fetus’ body, which can increase the risk of miscarriage or stillbirth. Prompt treatment can decrease the size of the cyst or eliminate it altogether.
Who gets a cystic hygroma?
Any baby can develop a cystic hygroma. They form as the result of a malformation or blockage during fetal development.
Doctors believe that cystic hygromas may be the result of a genetic change that occurs during the baby’s development, altering how the lymphatic system forms and functions. Instead of flowing through the baby’s bloodstream, the lymph fluid collects under the skin instead. This causes the sac of fluid, or cyst, to form. These cysts can be more common in children diagnosed with other genetic conditions, such as:
- Down syndrome
- Noonan syndrome
- Turner syndrome
Though they most often occur in infants and children, adults can also develop cystic hygromas. These are very rare and typically form as the result of physical trauma or a severe respiratory infection.
How is a cystic hygroma diagnosed?
During pregnancy, a routine prenatal ultrasound can reveal the presence of a cystic hygroma. There are also prenatal tests that can monitor the number of chromosomes in your child’s body. If these tests suggest that your child may have a predisposition to cystic hygromas, your doctor will carefully monitor fetal development to ensure its progressing successfully.
After your baby is born, your doctor can perform a physical examination to diagnose a cystic hygroma.
When is surgery needed?
Once your doctor diagnoses your baby with a cystic hygroma, they will refer you to a pediatric surgeon. Your doctor will determine the most appropriate course of treatment.
Most hygromas are successfully removed by a two-part approach. This includes an injection to drain fluid from the cyst, combined with the full removal of the cystic hygroma. This procedure ensures the hygroma is eliminated and helps prevent an infection from forming at the site.
What can I expect during surgery?
Your child will have a small incision site at the location of the cyst. The doctor may also need to place a small drainage tube at the site to drain excess fluid after removing the cyst.
Day of Surgery
On the day of your child’s surgery, you can bring their favorite soft toys or stuffed animals to comfort them and help them relax. You can also bring their favorite pajamas or play clothes so they can change into something more comfortable after the initial recovery period.
Leaving the Hospital
Most children can leave the hospital and go home within 24 to 48 hours after the surgery. They must have a normal temperature to be discharged and should be able to eat, drink, and take pain medications orally.
Post-Surgery Care at Home
Your surgical care team will walk you through all the steps required to help your child heal fully from their cystic hygroma surgery.
Each child will have their own set of protocols to follow, depending on the exact treatment they received and their specific condition. However, these basic guidelines apply to most patients.
Often, children will go home with a small drain still placed into the incision site to help remove access fluid. Most drains are required to stay in place for at least one week.
It’s important to keep the site of the surgical incision clean and dry for at least one week. You may help your child take a shower three to five days after their surgery, and they can take a bath after seven days. If they need to bathe earlier than this, sponge baths are typically allowed.
There are no dietary restrictions following cystic hygroma surgery. Your child is free to resume their normal diet as soon as they arrive back home.
Even if your child’s energy levels return immediately, allow them to rest and recover at home before jumping back into strenuous activities.
If your child is school age, they should be able to go back to school one week after their surgery. Their surgeon can tell you when it’s safe for them to resume school sports or participate in physical education classes. Until permissible, they
should also avoid lifting anything heavier than 10 pounds.
To keep your child comfortable, your surgeon can provide a prescription for pain medicine. You can also ease the symptoms by using over-the-counter pain medication, such as (Tylenol®) or ibuprofen (Motrin®).
Monitoring for Emergency Symptoms
If your child develops any of the following symptoms after arriving at home, please call your doctor immediately.
- Fever higher than 101 degrees Fahrenheit
- Loss of appetite
- Severe abdominal pain
- Redness, inflammation, or drainage at the incision site
Some children may also develop symptoms that mimic those of a common cold or upper respiratory infection. Contact your pediatrician if you notice any of these symptoms during their recovery period:
- Runny nose
- Sore throat