Ovarian lymphangioma resected during abdominal hysterectomy: A case report

Ovarian lymphangioma, a rare pathologic finding, is an ovarian mass characterized by lymphatic tissue lined with endothelial cells. It is normally asymptomatic and may be found incidentally during abdominal surgery for other pathologies. This report describes a case of a 49-year-old woman presenting to her primary care physician for three months of abdominal bloating and irregular menses. Magnetic resonance imaging revealed a 31 x 23 x 20 cm uterine mass suspected to be the cause of her symptoms. Total abdominal hysterectomy and bilateral salpingectomy were performed. During surgery, the right ovary was flattened and densely adhered to the body of the uterus, necessitating right oophorectomy. Pathology of the right ovary revealed flattened endothelial cells lining cystic spaces, consistent with the diagnosis of ovarian lymphangioma. Taken together, this case and the literature suggest that ovarian lymphangioma should be considered in the differential of ovarian masses, and their management shared more widely to help encourage the development of standard practice guidelines. There are no clear guidelines for when, and how often, to monitor these lesions after resection. In this case, the patient was seen at two-week and six-week follow-up visits with no new symptoms. Given that some case reports describe malignant transformation, patients should be followed this closely in the post-surgical period, and the best cadence for follow-up should be determined to improve outcomes.