Ultrasound guided intralesional bleomycin therapy for cystic lymphangioma in childhood

Abstract

Background: Lymphangiomas are benign hamartomatous lymphatic tumors, characterized by multiple communicating lymphatic channels and cystic spaces. They occur in nearly all regions of the body but are most frequently seen in the neck (75%), axilla (20%), and inguinal areas (2%). This study aims to evaluate the effectiveness of intralesional bleomycin sclerotherapy in the treatment of cystic lymphangioma in children and to determine the incidence of complications in the treatment.Methods: This is a prospective study of 36 children diagnosed with cystic lymphangioma and treated with intralesional injection of bleomycin aqueous solution from 2008 to 2015.Results: Complete resolution was seen in (16/36) of lesions, (17/36) had a good response and (3/36) had a poor response. The tumour recurred in 3 patients. No other serious complications or side effects were observed.Conclusions: Intralesional bleomycin therapy was very effective in the treatment of cystic lymphangioma. Our results were comparable to other published studies. Bleomycin administered as intralesional injection was found to be safe as there was no serious complication or side effect observed in this study.

Simulated Angiography Using a Bleomycin Mixture for Sclerotherapy of Lymphatic Malformations

“…Various agents, such as bleomycin, OK-432, alcoholic solution and doxycycline, have been used for percutaneous sclerotherapy. Pradyumna et al (14) reported complete resolution in 16 (44.4%), good in 17 (47.2%), poor in 3 (8.3%) patients, and repeated treatment in 33 (92%) patients treated with bleomycin. In a study including 17 cases of lymphangioma, Erikçi et al (15) reported good response in 50% of the lesions, complete resolution in 35.7%, and poor response in 14.3%.…”

“…Previous investigations have revealed that there is no consensus regarding the type of sclerosant such as picibanil (OK-432) and bleomycin. A prospective study showed that out of five patients of mixed variety, two (40%) showed good response and three (60%) showed a poor response and more frequency of treatment has been reported (14,16). The reason for this is that it is not intuitive to determine the distribution of drugs usually through image guidance performed with only US.…”

The Treatment of Lymphangiomas with Bleomycin in Childhood: A Retrospective Observational Study

“…L ymphangioma is defined as the congenital malformation of the lymphatic system. Defective connections of lymphatic ducts to the venous system, abnormal budding of lymphatic tissue and lymphatic sequestration that maintains the potential for regrowth are theories that have been proposed as potential causes of the disease [1][2][3][4] . Although lymphangioma may occur in any part of the body, it is most often seen in the neck and head.…”