CERVICAL CYSTIC LYMPHANGIOMA IN AN INFANT TREATED WITH SIROLIMUS: Report of a Rare Case and Literature Review

Cervical cystic lymphangioma is a rare congenital lymphatic malformation in infants, often challenging to treat surgically when extensive or adjacent to vital structures. We report the case of a two-and-a-half-month-old male infant presenting with a rapidly enlarging left lateral cervical mass detected at one month of age. MRI revealed an extensive cystic lymphangioma displacing the pharyngeal wall and internal carotid artery, confirmed by pathological analysis. Due to surgical risks, a conservative treatment with oral sirolimus, combined with a short course of corticosteroids and antibiotic prophylaxis, was initiated. After ten months, the mass completely regressed without complications. Sirolimus, an mTOR inhibitor, blocks endothelial lymphatic cell proliferation and angiogenesis, explaining its effectiveness even in extensive lesions. This case demonstrates the feasibility, safety, and efficacy of medical management, as discussed in our report. 

Keywords: Cystic lymphangioma, Cervical, Infant, Sirolimus, Lymphatic malformation, Conservative treatment