Successful pain control of lymphangioma-suspected lesions in pregnancy with acetaminophen and opioids: A case report and literature review

Abstract

Lymphangioma causing pain during pregnancy is not widely reported, but surgical treatment was performed in each of the reported cases. In our patient, lesions arose in the retroperitoneal cavity and caused intense pain from 17 weeks of gestation. However, surgical treatment was considered difficult because of the location of the lesion. The maximum dose of acetaminophen was administered, but pain relief remained unsatisfactory, and there were concerns about possible side effects of long-term use of high-dose acetaminophen on the fetus. Following attempts to control pain and reduce the acetaminophen dose, adding opioids was effective in controlling the pain and minimizing both dosages as much as possible. The patient was able to continue her pregnancy to term, avoiding highly invasive surgery during pregnancy. The combination of acetaminophen and opioids is reported here as an alternative treatment option to surgical procedures for intense pain caused by lesions such as lymphangioma in pregnancy.