Background and Aims Abdominal cystic lymphangiomas are uncommon congenital benign tumors. 90% are diagnosed by the age of 2 years. Retroperitoneal and mesenteric localizations account for less than 5% of paediatric lymphangiomas. Clinical presentation is variable: they can be incidental findings in prenatal or postnatal period, they can be symptomatic and present with chronic non-specific abdominal signs (pain, progressive distension), but most commonly they present acutely (infection, haemorrhage, rupture, torsion). We retrospectively reviewed three cases.

Materials and Methods Patient 1 had a prenatal diagnosis of intraperitoneal cystic mass; he underwent postnatal ultrasound follow up and RMN evaluation; at the age of 5 month was performed a laparoscopic exploration, in another hospital, but no mass was identify. We conducted a videoassisted resection of a mesenteric cystic lymphangiomas at the age of 7 months. Patient 2 (3 years and 8 months) and patient 3 (5 years and 10 months) presented with acute abdominal sign; laboratory tests and radiological and ultrasound evaluations were performed. Both patients underwent emergent laparotomy that permitted excision of a giant retroperitoneal cystic lymphangioma.

Results Postoperative recovery was uneventful. Follow up consisted on clinical and ultrasound monitoring. Patients have no recurrence.

Conclusions Complete surgical excision represents the treatment of choice for abdominal cystic lymphangiomas. Prognosis is excellent after surgery; a low recurrence rate exists when there is not a radical resection.