case_images: PMC6451791_01
case_images: T1+ contrast coronal MRI demonstrates a large mixed-cystic LM extending from the left neck into the chest with recent hemorrhage, measuring 8.1 x 5.7 x 5.5 cm.
case_images: CRIOT2019-2076798.001.jpg
case_images: PMC6451791_01_CRIOT2019-2076798.001.jpg
case_images: fig1
case_images: MRI of the neck on day of life (DOL) 3 showed a very large multiloculated and multispatial mass (Figure 1) within the left neck extending from the left inferior periauricular region through the upper chest with extension across the midline (de Serres stage V).
case_images: Prior to sirolimus treatment, there is significant mass effect involving the tongue, floor of mouth, and neck. After eight months of sirolimus treatment, the patient is able to close her mouth around her tongue and has markedly decreased mass effect on the face, mouth, and neck.
case_images: CRIOT2019-2076798.002.jpg
case_images: PMC6451791_01_CRIOT2019-2076798.002.jpg
case_images: fig2
case_images: She underwent tracheostomy on DOL 17 and required respiratory support for a total of 56 days before weaning to the trach collar (Figure 2(a)). Her functional improvement includes now being able to close her mouth around her tongue (Figure 2(b)).