Cross-sectional study comparing different therapeutic modalities for cystic lymphangiomas in children

Here, we describe our experience with different therapeutic modalities used to treat cystic lymphangiomas in children in our hospital, including single therapy with OK-432, bleomycin and surgery, and a combination of the three modalities. We performed a retrospective, cross-sectional study including...

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Bibliographic Details
Published in:	Clinics (São Paulo, Brazil) Vol. 69; no. 8; pp. 505 - 508
Main Authors:	de Oliveira Olímpio, Hugo, Bustorff-Silva, Joaquim, de Oliveira Filho, Antonio Gonçalves, de Araujo, Kleber Cursino
Format:	Journal Article
Language:	English
Published:	Brazil Elsevier España, S.L.U 01-08-2014 Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Faculdade de Medicina / USP Elsevier España
Subjects:	Bleomycin Bleomycin - therapeutic use Brazil Child, Preschool Clinical Science Combined Modality Therapy - methods Cross-Sectional Studies Cystic Female Follow-Up Studies Head and Neck Neoplasms - therapy Humans Infant Injections, Intralesional Lymphangioma Lymphangioma, Cystic - therapy Male MEDICINE, GENERAL & INTERNAL Picibanil Picibanil - therapeutic use Punctures - methods Remission Induction Retrospective Studies Sclerosing Solutions - administration & dosage Sclerosing Solutions - therapeutic use Treatment Outcome Brazil Cystic Bleomycin Picibanil Lymphangioma
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Summary:	Here, we describe our experience with different therapeutic modalities used to treat cystic lymphangiomas in children in our hospital, including single therapy with OK-432, bleomycin and surgery, and a combination of the three modalities. We performed a retrospective, cross-sectional study including patients treated from 1998 to 2011. The effects on macrocystic lymphangiomas and adverse reactions were evaluated. Twenty-nine children with cystic lymphangiomas without any previous treatment were included. Under general anesthesia, patients given sclerosing agents underwent puncture of the lesion (guided by ultrasound when necessary) and complete aspiration of the intralesional liquid. The patients were evaluated with ultrasound and clinical examinations for a maximum follow-up time of 4 years. The proportions of patients considered cured after the first therapeutic approach were 44% in the surgery group, 29% in the bleomycin group and 31% in the OK-432 group. These proportions were not significantly different. Sequential treatment increased the rates of curative results to 71%, 74% and 44%, respectively, after the final treatment, which in our case was approximately 1.5 applications per patient. The results of this study indicate that most patients with cystic lymphangiomas do not show complete resolution after the initial therapy, regardless of whether the therapy is surgical or involves the use of sclerosing agents. To achieve complete resolution of the lesions, either multiple operations or a combination of surgery and sclerotherapy must be used and should be tailored to the characteristics of each patient.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 Olimpio HO, Bustorff-Silva J and Oliveira Filho AG reviewed the data and wrote the manuscript. Araujo KC performed all the ultrasounds.
ISSN:	1807-5932 1980-5322 1980-5322
DOI:	10.6061/clinics/2014(08)01