title: Treatment of lymphangiomas in children: an update of Picibanil (OK-432) sclerotherapy.
abstract: Picibanil (OK-432) is a sclerosing agent derived from a low-virulence strain of Streptococcus pyogenes that induces regression of macrocystic lymphangiomas. This report describes a prospective, nonrandomized trial to evaluate the efficacy of Picibanil in the treatment of 13 affected children ranging in age from 1 to 94 months. On average, 4.1 fluoroscopically guided intracystic injections were performed per child, with an average total dose of 0.56 mg of Picibanil. As judged by physical examination and radiographic studies, 5 children (42%) showed a complete or substantial response, and 2 children (16%) showed an intermediate response. No response was seen in 5 children (42%), 2 of whom had massive craniofacial lymphangioma. Factors that contribute to failure with Picibanil sclerotherapy are the presence of a significant microcystic component to the lesion, massive craniofacial involvement, and previous surgical resection. Macrocystic lymphangiomas of the infratemporal fossa or cervical area have the best response to therapy.
authors.affiliation: Division of Pediatric Otolaryngology, Department of Otolaryngology, University of Iowa, Iowa City, 52242, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Greinwald
authors.forename: D K
authors.initials: DK
authors.lastname: Burke
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
authors.forename: R I
authors.initials: RI
authors.lastname: Poust
authors.forename: K
authors.initials: K
authors.lastname: Kimura
authors.forename: N M
authors.initials: NM
authors.lastname: Bauman
authors.forename: R J
authors.initials: RJ
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005153:Facial Neoplasms / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D015552:Injections, Intralesional; D008202:Lymphangioma / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D010039:Otorhinolaryngologic Neoplasms / Q000628:therapy*; D010844:Picibanil / Q000627:therapeutic use*; D011446:Prospective Studies; D015911:Sclerotherapy; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010844:Picibanil