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CHALLENGES IN MANAGING A RARE LYMPHATIC MALFORMATION WITH PALATAL
EXTENSION: A CASE REPORT

Ng YM, Sockalingam G, Sharif JM

Introduction: Cystic hygroma of the neck is a relatively rare congenital malformation of
lymphatic system. The extension of this type of lymphatic malformation to oral cavity
region usually involves floor of mouth and tongue; rarely to palatal region. Cervicofacial
cystic hygroma often leads to airway obstruction, dysphagia and speech pathology. Case
report: A 5-month-old infant with cystic hygroma was referred to Department of Paediatric
Dentistry Tunku Azizah Hospital, Kuala Lumpur due to chronic bleeding from hard palate.
The intermittent bleeding had caused feeding disturbances and chronic blood loss leading
to anaemia. Magnetic Resonance Imaging (MRI) reveals extension of lymphatic
malformation at right neck region to parapharyngeal space and palate. A consensus was
made at the multidisciplinary meeting to excise the palatal lesion locally and manage the
rest of the lesion pharmacologically with sirolimus. Excisional biopsy was performed under
general anaesthesia. Intra-operatively, no massive bleeding episode encountered. Upon
one year follow up, no bleeding symptoms reported and no sign of recurrence noted.
Besides, he was gaining weight well and managed concurrently with Paediatric
Dermatology team. Palatal extension of cystic hygroma is rarely reported in literature.
Hence, scientific evidence in regards to management of this lesion is scarce. Conclusion:
This case report highlights a need for multidisciplinary approach and early surgical
intervention in solving feeding problems of Cystic hygroma diagnosed patient.

Presented at the 5 MAPD Biennial Scientific Conference & Trade Exhibiton on 13 April 2019
th
th
Dr Ng Yan Mei
Dr Ganasalingam A/L Sockalingam
Department of Paediatric Dentistry
Tunku Azizah Hospital
Kuala Lumpur

Dr Jama’iah Mohd Shariff
Dental Centre
Sunway Medical Centre Sdn. Bhd
Selangor Malaysia

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