Cystic Hygroma
Frank H Miller, MD
Faye C Laing, MD
June 8, 1994
Presentation
This case from 1992 was a routine prenatal ultrasound examination.
Imaging Findings
Ultrasound Examination
Ultrasound shows a large cystic mass (arrows) posterior to the
fetal neck. The mass is anechoic and contains a septation (arrow).
Differential Diagnosis
The differential diagnosis for neck masses includes encephalocele,
meningomyelocele, and teratoma. Teratomas are uncommon and are generally
solid. Encephaloceles have associated calvarial abnormalities and contain
brain tissue. Meningomyeloceles are uncommon in the cervical region and
have associated spine abnormalities.
Diagnosis
Cystic hygroma
Discussion
Cystic hygromas, which usually occur in the neck, are most likely due
to abnormal lymphatic development. Approximately half of these
fetuses have monosomy X (Turner syndrome), while 10-15% of cases have
trisomy 18, 21 or 13. Cystic hygromas are midline, posterior,
septated, cystic masses without associated bone defects. They
frequently contain a characteristic appearing midline nuchal ligament.
References
1. Mahony BS, Hegge FN. The face and neck. In: Nyberg DA, Mahony BS,
Pretorias DH, editors. Diagnostic ultrasound of fetal anomalies.
Chicago: Year Book Medical Publishers, 1990:203-261.
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Ultrasound Examination
