Lymphatic and Mixed Malformations

Hathaway, Brynn A.; Radu, Stephanie; Wilson, J. Douglas

doi:10.1089/lrb.2020.0100

Cited by 3 publications

(4 citation statements)

References 45 publications

(72 reference statements)

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“…Lymphatic malformations (LMs) are common diseases in the pediatric population. Macrocystic, microcystic, and mixed-type are the three categories of LMs, classified based on the diameter of cysts, with cutoffs of 1 cm or 2 cm ( 5 ). The head and neck are the most commonly affected areas, accounting for approximately 50% of all LMs ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic-assisted sclerotherapy in pediatric retroperitoneal lymphatic malformations

Shi,

Lv,

et al. 2024

Front. Pediatr.

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BackgroundRetroperitoneal lymphatic malformations (LMs) are rare. Currently, the treatment of retroperitoneal LMs remains challenging. This study aimed to examine the safety and efficacy of laparoscopic-assisted sclerotherapy for retroperitoneal LMs in pediatric patients.MethodsWe retrospectively reviewed patients treated with laparoscopic-assisted sclerotherapy for retroperitoneal LMs in a single tertiary medical center between July 2020 and February 2023. Doxycycline was prepared into a solution with a concentration of 10 mg/ml for use in sclerotherapy. Demographic data, clinical features, details of management, and outcomes were collected and analyzed.ResultsA total of six patients, comprising three males and three females, were identified. The LMs were categorized into four macrocystic and two mixed-cystic types. The mean age and weight were 52.2 months (range, 11–108 months) and 20 kg (range, 12.5–27.5 kg), respectively. Three patients presented with abdominal pain or distension, while the other three patients were asymptomatic. All six patients underwent a total of eight sclerotherapy sessions. Two patients experienced intra-cystic hemorrhage and required a second sclerotherapy session. Only one patient presented with vomiting after sclerotherapy, which resolved spontaneously. Five patients met the complete response criteria, and one patient met the effective criteria. The mean reduction in lesion size was 92.3% (range, 69.9%–99.6%). No further complications or recurrence were recorded during follow-up.ConclusionLaparoscopic-assisted sclerotherapy is a safe and effective approach for treating retroperitoneal LMs. This technique is applicable for both macrocystic and mixed-cystic retroperitoneal LMs.

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Section: Discussionmentioning

confidence: 99%

“…The main methods include surgery, sclerotherapy, oral medication therapy, and observative treatment ( 10 ). Management requires the coordinated efforts of specialists in both medical and surgical fields and should be tailored to the size, location, symptoms, and category of the lesions ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic-assisted sclerotherapy in pediatric retroperitoneal lymphatic malformations

Shi,

Lv,

et al. 2024

Front. Pediatr.

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“…Microcystic LMs present with cysts <1–2 cm and often show a more aggressive growth pattern, whereas mixed cystic LMs show a combination of both and are more frequent in central parts of the body. Lymphatic malformations with microcystic components are more difficult to treat with high recurrence rates after attempted resection (>20%) 162 . Sclerotherapy is a treatment option further discussed below.…”

Section: Lymphatic Diseases Overviewmentioning

confidence: 99%

“…Lymphatic malformations with microcystic components are more difficult to treat with high recurrence rates after attempted resection (>20%). 162 Sclerotherapy is a treatment option further discussed below. Because of high recurrence rates after local therapy and even possible worsening due to induction of further growth, medical therapy of LMs is gaining importance (eg, sirolimus).…”

Section: Lymphatic Malformationsmentioning

confidence: 99%

Back to the Future II—A Comprehensive Update on the Rapidly Evolving Field of Lymphatic Imaging and Interventions

Pieper

2023

Invest Radiol

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Lymphatic imaging and interventional therapies of disorders affecting the lymphatic vascular system have evolved rapidly in recent years. Although x-ray lymphangiography had been all but replaced by the advent of cross-sectional imaging and the scientific focus shifted to lymph node imaging (eg, for detection of metastatic disease), interest in lymph vessel imaging was rekindled by the introduction of lymphatic interventional treatments in the late 1990s. Although x-ray lymphangiography is still the mainstay imaging technique to guide interventional procedures, several other, often less invasive, techniques have been developed more recently to evaluate the lymphatic vascular system and associated pathologies. Especially the introduction of magnetic resonance, and even more recently computed tomography, lymphangiography with water-soluble iodinated contrast agent has furthered our understanding of complex pathophysiological backgrounds of lymphatic diseases. This has led to an improvement of treatment approaches, especially of nontraumatic disorders caused by lymphatic flow abnormalities including plastic bronchitis, protein-losing enteropathy, and nontraumatic chylolymphatic leakages. The therapeutic armamentarium has also constantly grown and diversified in recent years with the introduction of more complex catheter-based and interstitial embolization techniques, lymph vessel stenting, lymphovenous anastomoses, as well as (targeted) medical treatment options. The aim of this article is to review the relevant spectrum of lymphatic disorders with currently available radiological imaging and interventional techniques, as well as the application of these methods in specific, individual clinical situations.

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