ENT Surgery at Manipal Hospital Broadway Saves 66-Year-Old from Rare Giant Neck Lymphangioma

Mumbai/Kolkata, 6th August 2026: What began as a slowly growing swelling on the right side of a 66-year-old mans neck eventually developed into a rare, giant tumour that threatened to compress his airway and some of the necks most critical blood vessels and nerves. In a highly complex surgery, doctors at Manipal Hospital Broadway successfully removed the massive 10 × 10 × 10 cm lymphangioma - a rare benign malformation of the lymphatic system, while carefully preserving the carotid artery, internal jugular vein and vagus nerve. The intricate procedure not only eliminated the tumour completely but also helped the patient recover without any post-operative complications.

The patient was admitted on 2 July with a swelling on the right side of his neck that had been gradually increasing in size for nearly one and a half years. Over the previous few months, the swelling had grown rapidly. A contrast-enhanced CT scan, conducted on 23 May, revealed a large 10 × 10 × 10 cm fluid-filled mass in the neck. The tumour was located very close to the right common carotid artery and the thyroid gland, while also pressing against the internal jugular vein and pushing the windpipe and voice box slightly to the left. These findings raised concerns that the swelling could affect the patients breathing if left untreated. Based on the scan, doctors suspected it to be a lymphangioma, a rare benign malformation of the lymphatic system.

Following a comprehensive pre-anaesthetic evaluation, the patient underwent complete surgical excision of the tumour under the leadership of Dr. Kaushik Das, Senior Consultant – ENT, Head & Neck Surgeon, Manipal Hospital Broaway, along with Dr. Ushirin Bose,Consultant -ENT ,Head &Neck Surgeon ,Manipal Hospitals .The anaesthesia team was led by Dr. Tushar Kanti Ghosh, Senior Anaesthesiologist.

During the surgery, doctors found a large, multi-chambered fluid-filled mass wrapped around some of the necks most important structures, including the carotid artery (the main artery supplying blood to the brain), the internal jugular vein and the vagus nerve. The surgery was particularly challenging because these vital structures had to be carefully separated from the tumour without causing any damage. The surgical team successfully removed the entire mass while preserving these critical blood vessels and nerves. Blood loss during the procedure was minimal, and a sample of the fluid from the cyst was sent for laboratory testing to confirm the diagnosis. Histopathological examination later confirmed the diagnosis, validating the teams initial clinical assessment.

Speaking about the case, Dr. Kaushik Das, said, "Lymphangiomas are uncommon benign malformations of the lymphatic system and are usually detected during childhood. While smaller lesions may simply be monitored, larger lesions like this one require complete surgical removal, particularly when they compress vital structures. In this case, the tumour had grown to a significant size and was closely related to the carotid artery, internal jugular vein and vagus nerve, making the surgery highly challenging. The key objective was to achieve complete excision while preserving these critical structures, as incomplete removal can lead to recurrence. We are pleased that the surgery was successful and the patient has made an excellent recovery."

Dr. Ushrin Bose, said, "One of the most challenging aspects of this surgery was the distorted anatomy caused by the giant lymphangioma. The tumour had displaced the carotid artery medially in the neck, leaving very little margin for error during dissection.Also , dissection was challenging to resect the lymphangioma en bloc without leaving any walls behind. Every step required meticulous planning and precise surgical technique to safely separate the mass while preserving the patients nerves and major blood vessels. Careful post-operative monitoring was equally important to ensure there were no breathing difficulties, nerve-related complications or wound issues. The patients smooth recovery and excellent functional outcome reflect the value of a coordinated multidisciplinary approach and timely intervention."

The patients post-operative recovery was uneventful. He remained haemodynamically stable with satisfactory pain control and experienced no complications. Daily assessments documented stable vital signs, minimal drain output, good oral intake and steady recovery. The drain was removed on the second post-operative day, following which the patient was discharged. During a follow-up visit seven days later, the surgical stitches were removed, and the patient was found to be recovering well without any complications.

Doctors noted that if left untreated, giant lymphangiomas can progressively enlarge and exert pressure on surrounding structures, leading to difficulty swallowing, breathing problems and significant discomfort. Early diagnosis and timely surgical intervention are essential to prevent these complications and ensure complete recovery.

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