Treatment of lymphatic malformations: A more conservative approach

Dror Gilony*, Michael Schwartz, Thomas Shpitzer, Raphael Feinmesser, Liora Kornreich, Eyal Raveh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

Background/Purpose: Lymphatic malformation is a benign disfiguring lesion of the neck and face in children. This study investigated the application and outcome of different modes of treatment. Methods: The medical files of all children with lymphatic malformation of the head and neck attending a tertiary medical center in 1999 to 2010 were reviewed. Findings were compared by treatment: surgery, OK-432 sclerotherapy, or observation. Results: The study group included 46 patients, most (65%) with macrocystic disease. Twenty were treated by OK-432 sclerotherapy, and 15, by surgery; 11 (with minor disfigurement) were observed only. Mean follow-up time was 2.4 years. Complete removal or complete response to treatment was achieved in 67% of the surgery group and 45% of the OK-432 group; fair results (> 50% reduction in swelling) were achieved in 20% and 50%, respectively. Sclerotherapy failure did not interfere with subsequent surgery. Complete spontaneous regression occurred in 5 patients under observation only. Conclusions: OK-432 sclerotherapy is associated with good aesthetic results in children with lymphatic malformation. Observation alone is sometimes sufficient. Surgery should be reserved for cases requiring a histologic diagnosis, microcystic disease, patients with an urgent clinical problem (eg, airway obstruction), and sclerotherapy failures.

Original languageEnglish
Pages (from-to)1837-1842
Number of pages6
JournalJournal of Pediatric Surgery
Volume47
Issue number10
DOIs
StatePublished - Oct 2012

Keywords

  • Lymphatic malformation
  • OK-432
  • Observation
  • Surgery

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