Massive symptomatic cystic hygroma confined to the thorax in early childhood.

A case of massive symptomatic cystic hygroma confined to the left hemithorax and mediastinum in a 21-month-old boy is reported. The symptoms were of increasing respiratory distress and cough with fever. The mass surrounded all of the major vascular and nervous structures of the mediastinum and left hemithorax and was attached to the pericardium. It was excised, and the postoperative course was complicated by prolonged chylothorax and malfunction of the left hemidiaphragm. Seven other reported symptomatic cases of cystic hygroma confined to the thorax in early childhood are reviewed. The hygromas tend to be large and their care typically is complex and complicated. Hemorrhage into the cysts is a frequent finding and likely contributes to the acute and progressive symptoms.