부산대학교 도서관

We report a case of a fetal lymphangioma of the waist complicated by intralesional bleeding. A 27-year-old woman, gravida 1, was referred to our hospital at 28 weeks of gestation for evaluation of a fetal lumbar mass. B-mode ultrasound showed a mass with uniformly low reflectivity. Color Doppler ultrasonography did not demonstrate blood flow in the mass. Magnetic resonance imaging（MRI）revealed a multicystic lymphangioma that measured 56×62 mm in size in the fetal waist. The mass gradually became larger in utero without echogenicity change. A female baby weighting 3,362 grams, Apgar scores 8 and 9 at 1 and 5 minutes, was delivered by elective cesarean section at 38 weeks and 6 days of gestation. A complete blood counts shortly after birth detected severe anemia with a hemoglobin level of 8.0g/dL requiring blood transfusion. The mass was surgically removed on postnatal day 7 and diagnosed as lymphangioma pathologically. The residual legion was treated with sclerotherapy using picibanil and carbon dioxide laser, and completely disappeared. No recurrence was observed during 4 months of follow-up. Ultrasonic examination and MRI are useful for antenatal diagnosis of intracystic hemorrhage in a lymphangioma. Careful consideration of the optimal timing and mode of delivery should be given for better neonatal outcome.