Pediatric cystic hygroma (CH)

What is a pediatric cystic hygroma (CH)?

A cystic hygroma is a lymphatic lesion that usually affects the head and neck and is caused by the obstruction of a lymphatic drainage pathway. Most cystic hygromas are evident at birth, with 80% to 90% of cases diagnosed before the child turns two years old.

What are the signs and symptoms of a pediatric cystic hygroma (CH)?

Cystic hygromas are seen at birth as soft, compressible, non-tender and translucent masses. The child may also have related complications, including respiratory distress, dysphagia and fever.

How is a pediatric cystic hygroma (CH) diagnosed?

During pregnancy, a cystic hygroma in the area of the neck can often be discovered during an ultrasound in the first trimester. A prenatal diagnosis is associated with other anomalies in at least 50% of cases.

These include:

• Turner syndrome
• Down syndrome

After birth, a physical exam will reveal cystic hygroma. Often, diagnosis is further confirmed by an ultrasound, which can also help to delineate the extensive nature of it beneath the skin level.

How is a pediatric cystic hygroma (CH) treated?

Respiratory distress and recurrent infections require treatment. The cyst can be aspirated as a temporary measure, to reduce its size and the pressure it places on the airway and feeding passages.

The suggested treatment is surgical removal. Surgery is performed to remove the abnormal tissue, but in 20% of cases it can reoccur. The outcome also depends on where these lesions are located. Beyond cosmetic damage, there could be an impact on the airway, nerves and blood vessels.