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Challenges in complete surgical resection of giant cystic hygroma

Background: Giant cystic hygroma is a benign cystic lesion that is disfiguring and a life threatening lymphatic malformation. Surgical resection is the main modality of treatment. Complete surgical resection of giant cystic hygroma is difficult and challenging. Patients and Methods: We discuss 10 cases of giant cystic hygroma wherein complete surgical resection was done. These cases were operated between 1996 and 2015. The preparation of patients, challenges, and outcome of the procedure were evaluated and recorded. Results: The age of the 10 cases we evaluated ranged from 1 month to 10 years. Five patients less than 1 year in age presented with respiratory embarrassment and feeding problems. Older children (5 patients) presented with disfigurement of face including visible non-tender mass. All children had some degree of feeding difficulties. One case had mediastinal involvement and presented with respiratory distress. Postoperatively, 6 patients had blood transfusion, while 5 required mechanical ventilation. Conclusion: This article focuses on difficulties encountered during surgical resection of giant cystic hygroma due to its varied clinical presentation, which is unique to the large size of the mass. These include anesthetic difficulties, operative difficulties in terms of identifying vital structures, bleeding, and cosmesis, and operative sequel and complications.