Symptom Resolution and Volumetric Reduction of Abdominal Lymphatic Malformations With Sclerotherapy

Madsen, Helen J.; Annam, Aparna; Harned, Roger K.; Nakano, Taizo A.; L, Larroque; Kulungowski, Ann M.

doi:10.1016/j.jss.2018.07.031

Cited by 32 publications

(27 citation statements)

References 29 publications

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“…Percutaneous interventions are controversial for ACL treatment [ 15 ]. Some researchers reported that sclerotherapy was effective for symptom resolution and volumetric reduction for pediatric patients with ACL [ 16 ]. More studies argued that aspiration, with or without injection of sclerosing substances, had a higher relapse rate in ACL [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of adult abdominal cystic Lymphangioma: a single-center Chinese cohort of 12 cases

et al. 2020

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Background Cystic lymphangioma is a rare, benign developmental disease, mostly affecting the cervical and axial regions. The clinical features of abdominal cystic lymphangioma (ACL) are reported among pediatric patients but are less well known in adults. The purpose of this study was to demonstrate the clinical characteristics of ACL in Chinese adults and describe our experience in treating this disease. Methods We conducted a single-center, non-interventional, retrospective study of 12 adult patients with ACL admitted to Peking Union Medical College Hospital in Beijing, China from November 1984 through August 2017. The demographic, clinical, laboratory, imaging, histopathologic, and therapeutic data were collected. Results Detailed information on seven males and five females was available. The mean age at diagnosis was 39.1 (SD 17.3) years. The mean duration of follow-up was 6.9 years. Six (50%) patients were asymptomatic, and abdominal pain was the leading symptom for three (25%) patients. The cysts were evaluated by ultrasound ( n = 8, 67%), CT ( n = 10, 83%), and MRI ( n = 4, 33%). Therapeutic modalities include laparotomy ( n = 6, 50%), laparoscopy (n = 4, 33%), and aspiration ( n = 2, 17%), with variable outcomes. The mean postsurgical hospital stay was 6.8 days. Complete excision was accomplished in eight patients, and one recurrence was observed during follow-up. Of patients who underwent partial resection, one experienced disease relapse. Conclusions This is the first report on an Asian cohort of adult patients with ACL. Typical imaging features could lead to timely diagnosis and treatment of ACL. Radical resection is recommended with a longer period of follow-up. The analysis of this cohort deepens our understanding of adult ACL.

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Section: Discussionmentioning

confidence: 99%

Characteristics of adult abdominal cystic Lymphangioma: a single-center Chinese cohort of 12 cases

et al. 2020

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“… 9 Our patient responded well with sclerotherapy. 10 , 11 In conclusion, given the paucity of clinical presentations involving omental lymphangioma masquerading as more traditionally observed disease processes, awareness of encounters such as these hold utility in acquainting providers with an expanded differential when treating patients who present similarly.…”

Section: Discussionmentioning

confidence: 99%

A Rare Presentation of Omental Lymphangioma Masquerading as Malignancy in an Adult Patient

et al. 2020

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Abdominal lymphangiomas are benign vascular neoplasms of the lymphatic vessels. Most are believed to be congenital, and they rarely present in the abdomen in adults. Omental lymphangiomas, in particular, are especially rare and can masquerade as malignancy, which requires further invasive workup. We report the case of an otherwise healthy man with abdominal discomfort, ascites, and a presentation initially concerning for malignancy. However, imaging and pathologic analyses later elucidated the lesion as an omental lymphangioma requiring different management. Treatment options are either resection or sclerotherapy, and the prognosis is generally excellent.

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“…Specifically, abdominal LMs, usually originating in the mesenteric region, were surgically treated and completely excised. Indeed, this technique has been historically considered the treatment of choice for abdominal LMs (30). However, a high complication rate (bleeding, iatrogenic damages, and deformity) has also been described (31), leading some authors to propose sclerotherapy also for cases with abdominal LMs, reporting good results (30,32,33).…”

Section: Discussionmentioning

confidence: 99%

Operative Management of Neonatal Lymphatic Malformations: Lesson Learned From 57 Consecutive Cases

et al. 2021

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Aim of the study: Lymphatic malformations (LMs) are rare entities, sometimes difficult to treat, that may be life-threatening when intricately connected to airway structures. Invasive treatments are occasionally required, with sclerotherapy considered the treatment of choice and surgery as a second-line approach. The aim of the present study was to evaluate our multidisciplinary team experience in treating newborns affected by LMs requiring operative management, while defining early outcomes.Methods: Retrospective review of all consecutive patients admitted for LMs requiring operative management between January 2000 and January 2019. Patients were mainly characterized based on anatomical district of the LM (and further stratified based on the development of respiratory distress), need for tracheostomy, number of sclerotherapies, indication for surgery, and residual disease beyond the 1st year. Morbidity and mortality were also evaluated. Fisher exact test and Mann–Whitney test were used as appropriate. Statistical significance was set at p < 0.05.Results: Fifty-seven patients were included in the study, 36 with cervicofacial and/or mediastinal LMs and 21 with LMs of other anatomical districts. Due to the risk of developing respiratory distress at birth, patients with cervicofacial and/or mediastinal LMs were divided into two groups (8/36 group A vs. 28/36 group B). Group A patients are at higher risk for tracheostomy (7/8 group A vs. 1/28 group B, p = 0.0001) and more often require surgical reduction of the residual lymphatic abnormality (5/8 group A vs. 4/28 group B, p = 0.013). They also require sclerotherapies more often, but the difference is not statistically significant (8/8 group A vs. 19/28 group B, p = 0.15). Patients with cervicofacial/mediastinal LMs frequently suffer from persistent residual disease beyond the 1st year of life, significantly more often in group A (7/8 group A vs. 12/28 group B, p = 0.043).Conclusion: LMs are rare conditions with potential life-threatening behavior. Their intrinsic clinical complexity requires a multidisciplinary approach to the affected patients. Planning a long-term follow-up is essential because of the late-term problems those patients may experience.

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Symptom Resolution and Volumetric Reduction of Abdominal Lymphatic Malformations With Sclerotherapy

Cited by 32 publications

References 29 publications

Characteristics of adult abdominal cystic Lymphangioma: a single-center Chinese cohort of 12 cases

Characteristics of adult abdominal cystic Lymphangioma: a single-center Chinese cohort of 12 cases

A Rare Presentation of Omental Lymphangioma Masquerading as Malignancy in an Adult Patient

Operative Management of Neonatal Lymphatic Malformations: Lesson Learned From 57 Consecutive Cases

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