Multispecialty Approach to a Very Large Congenital Head and Neck Cystic Lymphatic Malformation in an Infant Born by SARS-CoV-2 Positive Mother-A Case Report

Masses of the head and neck are often diagnosed prenatally and require special care due to the risk of airway obstruction. The EXIT procedure is a preferable mode of delivery. A congenital cystic lymphatic malformation is one of the most common lesions of the cervical region described in neonates. The treatment consists of different strategies and involves the cooperation of multiple specialists. Up to now, no guidelines or protocols are available. We report a case of a congenital cystic lymphatic malformation of the head and neck delivered during the EXIT procedure by a mother who was SARS-CoV-2 positive. We analyzed clinical characteristics, radiologic features, and treatment with injections of sclerotic agents and orally administrated sirolimus. Sirolimus seems a valuable and safe therapeutic option for treating lymphatic malformations, especially with adjunct therapies.

Automated summary

Masses in the head and neck area are commonly diagnosed before birth and require special care to prevent airway obstruction. The EXIT procedure is a preferable mode of delivery. Congenital cystic lymphatic malformation is one of the most frequent lesions in the neck area of newborns, and its treatment involves the collaboration of multiple specialists with no available guidelines or protocols. In this case study, we report a newborn with a congenital cystic lymphatic malformation in the head and neck area delivered during the EXIT procedure by a mother who tested positive for SARS-CoV-2. We analyzed the clinical characteristics, radiologic features, and treatment involving sclerotic agent injections and oral administration of sirolimus. Sirolimus appears to be a valuable and safe therapeutic option for lymphatic malformations, particularly when used in combination with adjunct therapies.