Treatment of lymphangiomas of the head and neck in children by intralesional injection of OK-432 (Picinabil)

Abstract

The treatments previously used for lymphangiomas of the head and neck in children-surgery and intralesional injection of sclerosants-are associated with significant morbidity. A new treatment-intralesional injection of OK-432-was used for lymphangiomas of the head and neck in 11 children. The results were total shrinkage in two, marked shrinkage in two, slight shrinkage in five and no response in two. The results were not affected by previous surgery nor by whether aspiration prior to injection was possible. There were no recurrences in those children in whom shrinkage occurred and no child had subsequent surgery following injection. The results of this series support those of previous series showing that OK-432 injection is an effective and safe treatment for lymphangiomas of the head and neck in children.

Treatment of lymphangioma in children: our experience of 128 cases

“…Thus, this is a retrospective study directly comparing the effectiveness of surgical excision and sclerotherapy. In this study, the effectiveness of sclerotherapy was 64% (including 2 BLM injection cases), which was the same as or less than other series [13][14][15][16]. Our technique for OK-432 injection was standard as described by Ogita et al [6]; however, sometimes injections could not be repeated exactly according to plan at 6-to 8-week intervals because of patient or parental reasons.…”

Lymphatic malformations: A proposed management algorithm

“…OK-432 (Picibanil, Chugai Pharmaceutical Co., Tokyo) is a lyophilized biologic preparation of group A Streptococcus pyogenes cells treated with benzylpenicillin and is therefore contraindicated in patients with a penicillin allergy [20]. There have been numerous reports on the successful use of OK-432 since then [1,2,20,22,23] and is increasingly being proposed as a first line treatment option in LMs. Compared to other sclerosants OK-432 has the advantage that following administration there is no perilesional fibrosis and therefore subsequent surgery is not made more difficult or hazardous [1,23,24].…”

Sclerotherapy for lymphatic malformations in children: a scoping review

“…Clear classification adherence for cyst type (ie, macrocystic, microcystic, and mixed) would also decrease the heterogeneity of the literature, which would be beneficial for future systematic reviews. Twenty-two studies were not included because the type was not stated [3,4,10,15,16,21,[24][25][26]29,30,33,[35][36][37][38]40,[42][43][44]52,53. Two studies were excluded because the results could not be placed into our established categories of success [18,45].…”