Definition — Subcutaneous Lymphatic Malformation (Cheek Soft Tissue): A subcutaneous lymphatic malformation is a benign congenital malformation of lymphatic channels, presenting as a multiloculated cystic lesion in the cheek soft tissue. It is composed of abnormal dilated lymphatic spaces and does not regress spontaneously. These lesions may be microcystic, macrocystic, or mixed in nature.
Ultrasound Report — Line: A well-defined, multiloculated cystic lesion is seen in the subcutaneous soft tissue of the left cheek, showing thin internal septations, anechoic to hypoechoic contents, and absence of internal vascularity on color Doppler. Surrounding fat planes are preserved with no muscle or bone involvement.
Conclusion: Findings are consistent with a Subcutaneous Lymphatic Malformation.
Recommendation: Further delineation with contrast-enhanced MRI may be useful for surgical planning.
Sonographic Features — Subcutaneous Lymphatic Malformation:
- Lesion: Well-defined, multiloculated cystic lesion.
- Internal septations: Thin septa dividing cystic compartments.
- Doppler: No internal vascularity within cystic spaces.
- Content: Anechoic to low-level echoes (proteinaceous/hemorrhagic material possible).
- Surrounding tissues: Fat planes preserved; no invasion into masticatory muscles or bone.
Causes / Etiology — Subcutaneous Lymphatic Malformation:
- Congenital developmental anomaly of lymphatic vessels (most common).
- Failure of lymphatic channels to connect with the venous system.
- Occasionally associated with infection or hemorrhage causing enlargement.
Symptoms / Clinical Features — Subcutaneous Lymphatic Malformation:
- Painless, soft, compressible swelling of the cheek.
- Gradual enlargement over time.
- Fluctuating size, may increase with infection or hemorrhage.
- Cosmetic deformity or facial asymmetry.
- Occasional pain or overlying skin discoloration if complicated.
Diagnostic Strategy — Subcutaneous Lymphatic Malformation:
- Ultrasound with Doppler: First-line modality to identify cystic nature, septations, and avascularity.
- MRI with contrast: Best for defining lesion extent, tissue involvement, and surgical planning.
- CT scan: Limited role; may help assess deeper tissue or bony relation.
- Differentials: Venous malformation, dermoid cyst, subcutaneous abscess, atypical hemangioma.
Declaration:
I, R. K. Mouj, hereby declare that the material presented in this document titled "Subcutaneous Lymphatic Malformation (Cheek Soft Tissue): Definition, Sonographic Features, Case Studies, and Risk Assessment" has been prepared and compiled by me for educational purposes only. It is intended for learning, training, and academic reference. Sources and references have been acknowledged where appropriate.
Ethics / Patient Data Statement: Any patient images, case material, or ultrasound examples included here are for academic use only, anonymised, and used with ethical consideration.
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