DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20172693

Ultrasound guided intralesional bleomycin therapy for cystic lymphangioma in childhood

Pradyumna Pan

Abstract


Background: Lymphangiomas are benign hamartomatous lymphatic tumors, characterized by multiple communicating lymphatic channels and cystic spaces. They occur in nearly all regions of the body but are most frequently seen in the neck (75%), axilla (20%), and inguinal areas (2%). This study aims to evaluate the effectiveness of intralesional bleomycin sclerotherapy in the treatment of cystic lymphangioma in children and to determine the incidence of complications in the treatment.

Methods: This is a prospective study of 36 children diagnosed with cystic lymphangioma and treated with intralesional injection of bleomycin aqueous solution from 2008 to 2015.

Results: Complete resolution was seen in (16/36) of lesions, (17/36) had a good response and (3/36) had a poor response. The tumour recurred in 3 patients. No other serious complications or side effects were observed.

Conclusions: Intralesional bleomycin therapy was very effective in the treatment of cystic lymphangioma. Our results were comparable to other published studies. Bleomycin administered as intralesional injection was found to be safe as there was no serious complication or side effect observed in this study. 


Keywords


Bleomycin, Lymphangioma, Sclerotherapy

Full Text:

PDF

References


Sabin FR. The lymphatic system in human embryos, with a consideration of the morphology of the system as a whole. A J Anat. 1909;9:43-91.

Giguere CM, Bauman NM, Smith RJ. New treatment options for lymphangioma in infants and children. Ann Otol Rhinol Laryngol. 2002;111:1066-75.

Brooks JE. Cystic hygroma of neck. Laryngoscope. 1973;83:117-28.

Molitch HI, Unger EC, Witte CL, van Sonnenberg E. Percutaneous sclerotherapy of lymphangiomas. Radiology. 1995;194(2):343-7.

Waner M, Suen JY. Treatment options for the management of vascular malformations. In: Waner M, Suen JY, editors. Hemangiomas and vascular malformations of the head and neck. New York: Wiley-Liss;1999:315-50.

Filston HC. Hemangiomas, cystic hygromas, and teratomas of head and neck. Semin Pediatr Surg. 1994;3:147-59.

Chait D. Management of cystichygromas. Surg Gynecol Obstet. 1974; 139:55-8.

Rozman Z, Thambidorai RR, Zaleha AM, Zakaria Z, Zulfiqar MA. Lymphangioma: is intralesional bleomycin sclerotherapy effective?. Biomed Imaging Intervention J. 2011;7(3).

Orford J, Barker A, Thonell S, King P, Murphy J. Bleomycin therapy for cystic hygroma. J Pediatr Surg. 1995;30:1282-7.

Yetiser S, Karaman K. Treatment of lymphangioma of the face with intralesional bleomycin: case discussion and literature review. J Maxillofacial Oral Surg. 2011;10(2):152-4.

V Kumar, P Kumar, A Pandey, D K Gupta, R C Shukla, S P Sharma et al. IntralesionalBleomycin in Lymphangioma: An Effective and Safe Non-Operative Modality of Treatment. J Cutan Aesthet Surg. 2012;5(2):133-6.

Charabi B, Bretlau P, Bille M, Holmelund M. Cystic hygroma of the head and neck- a long-term follow-up of 44 cases. Acta Otol Aryngol Suppl. 2000;543:248-50.

Rawat JD, Sinha SK, Kanojia RP, Wakhlu A, Kureel SN, Tandon RK. Non surgical management of cystic lymphangioma. Indian J Otolaryngol Head Neck Surg. 2006;58(4):355-7.

Niramis R, Watanatittan S, Rattanasuwan T. Treatment of cystic hygroma by intralesionalbleomycin injection: Experience in 70 patients. Eur J Pediatr Surg. 2010;20:178-82.

Sainsbury DC, Kessell G, Fall AJ, Hampton FJ, Guhan A, Muir T. Intralesionalbleomycin injection treatment for vascular birthmarks: A 5-year experience at a single United Kingdom unit. Plast Reconstr Surg. 2011;127:2031-44.

Okada A, Kubota A, Fukazawa M, Imura K, Kamata S. Injection of bleomycin as a primary therapy of cystic lymphangioma. J Pediatr Surg. 1992;27(4):440-3.

Niramis R, Watanatittan S, Rattanasuwan T. Treatment of cystic hygroma by intralesionalbleomycin injection: Experience in 70 patients. Eur J Pediatr Surg. 2010;20:178-82.

Baskin D, Tander B, Bankaoglu M. Local bleomycin injection in the treatment of lymphangioma. Eur J Pediatr Surg. 2005;15:383-6.

Kertesz Z, Bala G, Bancu S, Gozar H, Virgil G, Horvath E, et al. Bleomycin therapy for lymphangioma. Chirurgia (Bucur) 2011;106:103-7.