Results of Ultrasonography-guided Intralesional Bleomycin Sclerotherapy for Treatment of Macrocystic Lymphangioma in Children and Comparison with traditional surgical methods

Abstract

Lymphangiomas are congenital anomalies of the lymphatic system that occur due to a lack of reabsorption of lymph nodes. Clinical manifestations range from asymptomatic cystic masses to masses that compress the airways. This study aimed to evaluate and compare the results and complications of macrocytic lymphangioma treatment with two sclerotherapy methods with bleomycin and traditional surgery. Materials and Methods: In this Non-Randomized Clinical Trial, the treatment results with macrocytic sclerosing intra-lymphangioma (cystic hygroma) are compared with traditional surgical methods. Patients are divided into two groups, A (sclerosing injection) and B (patients treated with conventional surgery), according to parental knowledge and consent. At the end of 6 months, the results of the response to treatment were evaluated, and patients who did not respond satisfactorily after the third dose of the drug were referred for surgery. Results: Thirty patients in two groups of 15 were studied. The mean age of the patients was 32.57±24.48 months, with a median of 11.50 months. Twelve patients (40%) were boys, and 18 patients (60%) were girls. At the final visit, the response to treatment in the bleomycin group was excellent in 53.3%, good in 40% and poor in 6.7%. In contrast, in the surgical group, the response to treatment was excellent in 6.7%, good in 73.3% and poor in 20% of patients. The mean dose of bleomycin injected after aspiration of cyst contents was 3.30±1.30 units. The lowest injected dose was two units, and the maximum was six units. Also, three patients (20%) needed re-injection of bleomycin in the second visit.