Giant mesenteric cystic lymphangioma in adult; rare tumor, unusual location and uncommon age of occurrence: A Tunisian case report S. Attafi * , W. Ajouli, N. Bouchiba, A. Chouchene, M. H. Balti, K. Bellil * FSI Hospital, Dept. of Pathology, Marsa, Tunisia Objective: Cystic lymphangioma is a rare benign neoplasm arising from the lymphatic system. It occurs as a result of congenital malformations of the lymphatics, leading to the obstruction of local lymph flow and the development of lymphangiectasia. Lymphangioma is common in pediatric patients, but it is extremely rare in adults, with only about 100 cases reported in literature. Most lymphangiomas are found in the head and neck; intraabdominal and specially mesenteric locations are very unusual. The aim of this work was to study its clinical, histological and therapeutic features and their diagnostic difficulties. Method: We report the case of a 46 years-old woman, who presented a painful syndrome of the right iliac fossae (RIF). The physical examination found a mass of the RIF. Abdominal ultrasonography and magnetic resonance image showed a mesenteric cystic formation. At laparotomy, a large cystic tumor of the caecal mesentery, measuring 23 cm, was found. Histopathology showed a fibrous and thin walled cyst, lined by flat low lying epithelium with surrounding tissue of scattered lymphoid cells. Results: The diagnosis of cystic lymphangioma was retained. Conclusion: Mesenteric lymphangiomas are very rare, but they can cause acute abdomen that requires an emergent surgery. Therefore, they should be included in the differential diagnosis of cystic intra-abdominal lesions raises several possibilities, including both malignant and benign soft tissue tumours. Objective: The spleen metastases from colon cancer are rare conditions and usually associated with extensive disease. There are only eight reports in English-language literature of isolated splenic metastases from colorectal carcinoma, which generally metastasize to regional lymph nodes, liver and abdominal peritoneum. Method: We report a case of multiple splenic metastases in a 60-year-old woman. Results: In November 2009, the patient had undergone right hemicolectomy, lymphadenectomy and chemotherapy for stage III tubular adenocarcinoma of the ascendant colon with positive pericolic lymph nodes. In December 2011, she was admitted in our hospital for diffuse abdominal pain and intestinal transit disorders. Computed tomography of the abdomen revealed multiple metastases of different sizes in liver and spleen. During the surgery, which was performed with the goal of curing metastatic disease, there were found two nodular hepatic secondary tumors, and numerous spleen metastases, with diameters from 0.2 cm to 1.5 cm. The histopathological evaluation of splenectomy specimen revealed a metastatic tumor deposit, histologically similar to the primary tubular adenocarcinomas of colon. Conclusion: This is the ninth documented case of splenic metastasis from colon cancer. Previously reported cases of this type were isolated tumor, this one being the first reported with multiple splenic metastases.