Treatment of Lymphangiomas in Children: An Update of Picibanil (OK‐432) Sclerotherapy

Abstract

Picibanil (OK-432) is a sclerosing agent derived from a low-virulence strain of Streptococcus pyogenes that induces regression of macrocystic lymphangiomas. This report describes a prospective, nonrandomized trial to evaluate the efficacy of Picibanil in the treatment of 13 affected children ranging in age from 1 to 94 months. On average, 4.1 fluoroscopically guided intracystic injections were performed per child, with an average total dose of 0.56 mg of Picibanil. As judged by physical examination and radiographic studies, 5 children (42%) showed a complete or substantial response, and 2 children (16%) showed an intermediate response. No response was seen in 5 children (42%), 2 of whom had massive craniofacial lymphangioma. Factors that contribute to failure with Picibanil sclerotherapy are the presence of a significant microcystic component to the lesion, massive craniofacial involvement, and previous surgical resection. Macrocystic lymphangiomas of the infratemporal fossa or cervical area have the best response to therapy.

OK432 Versus Doxycycline for Treatment of Macrocystic Lymphatic Malformations

“…Previous reports have stated that surgical 86 Motz et al, OK432 Versus Doxycycline for Lymphatic Malformations excision is not more complicated after OK432 sclerotherapy. 2,3,[22][23][24]27,28 We found this to be true in the excision of an organized hematoma.…”

“…The clinical response to therapy as measured by clinical examination was based on the criteria of Smith and colleagues: greater than 90% reduction was classified as a complete response, 60% to 89% reduction as a substantial response, 20% to 59% reduction as an intermediate response, and less than 20% reduction as no response. 3,28 Clinical success was defined as a complete or substantial response. Statistical assessment was completed with SPSS data software.…”

Malformación linfática facial mixta: Caso clínico

“…Al inyectarse OK-432 genera una reacción inflamatoria local y posterior reducción de la masa tumoral por adhesión y subsecuente fibrosis intraluminal de los vasos [8][9][10][11][12][13] . Existen reportes referentes a resultado exitoso después de un promedio de 2 infiltraciones en LM macro/uniquisticas y 6 veces para el tipo microquístico [14][15][16] .…”

Dilden Köken Alan Lenfanjiomanın Radyoferkans İle Ablasyonu Ablation of a Lymphangioma That Arose From Tongue by Radiofrequency

“…Lenfanjiomlar nadir lezyonlar olup en sık tutulum baş boyun bölge-sinde olmaktadır (6). Çocukluk yaş benign tümörlerinin %6'sını oluşturan bu lezyonlar, hemanjiomalardan farklı olarak gerçek vasküler malformasyon olarak kabul edilir ve zaman içerisinde involusyona uğramazlar (7).…”