A newborn has a swelling in neck due to soft cystic mass with trans-illumination test positive. Diagnosis is?

Ans. (c) Cystic hygromaRef : Bailey & Love 26th ed. / 701CYSTIC HYGROMA/LYM PH ANGIOMA* Cystic hygromas are multiloculated cystic swelling Filled with clear lymph lined by endothelial cells* It results due to sequestration of a portion of the jugular lymph sac from the lymphatic system.* It is associated with Turners syndrome* Most cystic hygromas involve the lymphatic jugular sacs* MC site: Posterior neck region* Other common sites: Axilla, mediastinum, inguinal and retroperitoneal regions* Approximately 50% of them are present at birth.* It may show spontaneous regression* The cysts are filled with clear lymph and lined by a single layer of endothelium epithelium.Clinical Features* Usually manifests in the neonates or in early infancy (50% present at birth).* Prone to infection and hemorrhage within the mass.* Usually present as soft masses that distort the surrounding anatomy, can result in acute airway obstruction.* Swelling is soft and partially compressible and invariably increases in size when the child coughs or cries.* Characteristic features: Brilliantly translucentDiagnosis: MRI plays a crucial role in preoperative planningTreatment: Complete surgical excision is the preferred treatment.Also Know* Usually manifests in the neonates or in early infancy presents in 5th decade with firm, rubbery, mobile mass.* Branchial cyst most commonly seen in older children or adolescents. However, all branchial remnants are present at the time of birth.