European Journal of Molecular & Clinical Medicine

Abstract

Idiopathic retroperitoneal lymphocele is an extremely rare entity. Their diagnosis and management is a challenge for many surgeons. This study addresses one such extremely rare case of idiopathic retroperitoneal lymphocele which was diagnosed and managed with the help of intranodal lymphangiography and embolization.
OBJECTIVE: This study aims to discuss an unusual clinical presentation of a case of idiopathic retroperitoneal lymphocele, the imaging modalities available for diagnosis and the various treatment options.
CASE PRESENTATION: A 56 year old male presented with vague abdominal discomfort on and off since last 3 years without any other significant history and a completely normal local and systemic examination. Radiological investigation with a USG guided pigtailing revealed a collection of turbid milky white fluid which was diagnosed as lymphocele on the basis of biochemical examination.MR lymphangiography raised a suspicion of a communicating lymphatic channel with the cystic cavity. Intranodal lymphangiography with lymphatic embolization was performed which showed successful therapeutic results.
CONCLUSION: Clinicians must be aware that though unusual, idiopathic retroperitoneal lymphocele can present as a differential diagnosis for retroperitoneal cystic mass. No diagnostic algorithm is yet available. Diagnosis necessitates a strong index of suspicion, proper radiographic assessment, and fluid biochemical tests