Intralesional bleomycin versus sodium tetradecyl sulphate in the management of peripheral lymphangiomas in children: a prospective comparative study

Abstract

Introduction: Surgical resection in lymphangiomas is associated with high rate of complications, recurrences and total excision is not possible in every case. Therefore, sclerotherapy have emerged as alternative mode of management. It is essential to know the efficacy of the sclerosants and the merits and demerits of the agents. However, a prospective study comparing the efficacies of the sclerosing agents exclusively on lymphangioma is lacking. Methods: A prospective, comparative clinical trial was conducted in a tertiary health care pediatric institute among lymphangioma patients. Patients were divided into two groups by randomisation; Group A: patients in whom intralesional bleomycin injection was administered, Group B: patients in whom intralesional sodium tetradecyl sulphatewas administered. Both the groups were compared with respect to clinical presentation, efficacy of the drugs and side effects/complications. Result: Out of 36 patients included in this study, 18 patients were treated with intralesional bleomycin and 18 patients with intralesional sodium tetradecyl sulphate. Most common site of lymphangioma was neck (44.5%) followed by axilla in 27.7% of cases. Reduction in size was noted in 15 (83.3%) patients in group A, 9 (50%) had excellent response, while 6 (33%) had good response. Reduction in size was noted in 12 (66%) patients in group B, 5 (27%) had excellent response while 7 (38%) had good response. Conclusion: Intralesional bleomycin and sodium tetradecyl sulphate are safe and effective sclerosing agents in peripheral lymphangiomas of children, but bleomycin is more effective in reducing the size of the lesions.