This poor woman has a recurrent cystic hygroma. She has had 2 surgeries as a child and 2 as an adult. The tumor is back againm. She is coming to see us in January. 

I would describe this disease as the bane of the head and neck surgeon's existence. These tumors are difficult to remove-the surgery can be long and tedious and it can be difficult to preserve important structures in the neck. If it is not completely removed, recurrence is common.

cystic hygroma (also known as cystic lymphangioma and macrocystic lymphatic malformation) is a congenital multiloculated lymphatic lesion that can arise anywhere, but is classically found in the left posterior triangle of the neck. This is the most common form of lymphangioma. It contains large cyst like cavities containing watery fluid. Microscopically cystic hygroma consists of multiple locules filled with lymph. In the depth the locules are quite big but they decrease in size towards the surface.

We will do our best to make this her last surgery!