Cystic Hygroma

Cystic hygroma was first described in 1843 by Wernher. It is a lesion in the lymphatics that affects the head and neck of the human body. This disease is also similar to cystic lymphangioma or macrocystic lymphatic malformation.

Cystic hygroma grows as the child also matures. The intralesional bleeding allows the growth potential of cystic hygromas.

Environmental Cause:

  1. Maternal viral infections (e.g. Parvovirus Fifth’s disease)
  2. Genetic syndromes – Turner syndrome, trisomies (13, 18 and 21)

Pathophysiology:

Normally, the lympatics would branch out in to the venous system. This failure of branching out will encourage growth of lymphatic tissue in an abnormal way. This unusual growth will penetrate near to the neck or head. The tissues might either be described as capillary, cavernous or cystic.

The vascular endothelial growth factor C (VEGF-C) has been found out to have a big role in the abnormal growth of development of lymphatic malformations.

Diagnostic Evaluation:

As early as 10 weeks of gestation, cystic hygromas can already be detected, however, a transvaginal ultrasound would give a better outline of the cyst. The alpha fetoprotein levels is also increased when the fetus has cystic hygromas.

Medical Management:

Administration of sclerosing agents such as OK-432, which is an active strain of group A Streptococcus pyogenes, bleomycin, pure ethanol and doxycycline. The OK-432 encourages inflammatory response leading to fibrosis of the hygroma. Aspiration during the procedure has something to do with the process of effective therapy.

Surgical Management:

Aside from aspiration, the excision of the hygroma is the only treatment known to be immediate and effective. The goal of surgical intervention is to either remove the lymphangioma.

Nursing Management:

  1. Proper education of the mother about the condition so that she may be able to cope effectively with the baby’s condition.
  2. Monitor the skin condition of the face and neck area. Provide proper skin care on the areas involved.
  3. Evaluate the therapy given as well as the response of the patient.
  4. Teach the mother or the care giver proper wound care so that they will be able to take care of the lesion properly when at home.

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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