Management of orbital lymphangioma using intralesional injection of OK-432.
OBJECTIVE
To treat orbital lymphangioma with an intralesional injection of OK-432 (group A Streptococcus pyogenes of human origin).


METHODS
A 14 year old boy had a right orbital cystic lymphangioma. The visual acuity in the eye was 20/28. In an initial treatment, 0.02 mg of OK-432, was injected into the tumour after aspiration of the fluid contents, but no effect was seen. The second treatment was performed with 0.04 mg of OK-432.


RESULTS
4 months later, the lesion had totally shrunk to fibrous tissue. The side effects were fever, a local inflammatory reaction lasting 3 days, and increased intraocular pressure, which was managed by draining the fluid contents. Visual acuity improved to 20/15, and the visual field defect and restriction of eye movement seen before treatment disappeared. No recurrence was noted 1 year after treatment.


CONCLUSIONS
An intralesional injection of OK-432 shrunk the lymphangioma without functional disturbance and scar in the facial skin. OK-432 may be useful for orbital lymphangioma, but further studies are still warranted to determine efficacy, complications, and the optimal dose for safe treatment.
Suzuki
Y
Y
Department of Ophthalmology, Osaka City University Medical School, Japan. m5253565@msic.med.osaka-cu.ac.jp
Obana
A
A
Gohto
Y
Y
Miki
T
T
Otuka
H
H
Inoue
Y
Y
D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D018191:Lymphangioma, Cystic / Q000188:drug therapy* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009918:Orbital Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010844:Picibanil / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D010844:Picibanil