Multifocal lymphangioma involving the liver, spleen, and retroperitoneum: A rare adult presentation.

Hepatic lymphangioma is an extremely rare benign tumor of the lymphatic system, especially in adults. It often presents as a cystic lesion and can mimic other hepatic or abdominal cystic diseases such as hydatid cysts or cystadenomas. Due to its rarity and nonspecific imaging features, diagnosis is often challenging and confirmed only by histopathology. We report a 40-year-old male who presented with several months of abdominal discomfort and mild distension. Physical examination revealed no tenderness, and laboratory results were within normal limits. Abdominal ultrasound showed multiple cystic lesions throughout the liver. Further CT and MRI imaging demonstrated multiple well-defined, hypodense cystic lesions in the liver, spleen, and retroperitoneal space. The largest lesion was located adjacent to the psoas muscle and anterior to the lumbar spine, showing an insinuating appearance characteristic of lymphangioma. Surgical excision and histopathological examination confirmed the diagnosis of hepatic and retroperitoneal lymphangioma. Intrahepatic lymphangioma is a rare benign lesion that can present with multifocal abdominal involvement. Awareness of this condition is important to avoid misdiagnosis and unnecessary extensive surgery. Complete surgical excision remains the definitive treatment, providing both diagnostic confirmation and excellent prognosis.