Mixed capillary/lymphatic malformation with coexisting port-wine stain: treatment utilizing 3D MRI and CT-guided sclerotherapy.
BACKGROUND
Lymphatic malformation, a benign malformation of the skin and the subcutaneous tissues, is divided into two major groups: the classical and the localized forms. Pathologically lymphatic malformation often consists of sequestered lymphatic cisterns with thick muscle walls lying deeply in the subcutaneous tissue. Communicating via dermal lymphatic channels with superficial pseudovesicles, they can vary in size depending on the pressure transmitted by the cisterns beneath.


METHODS
We present a patient with mixed capillary/lymphatic malformation and coexisting port-wine stain since birth. To demonstrate the anatomic extent and the subcutaneous involvement we performed a 3D reconstruction of a magnetic resonance imaging (MRI). The diagnostic procedures, therapeutic possibilities, and complications regarding this rare appearance are reviewed.


RESULTS
Good results could be obtained with CO2 laser vaporization of the superficial lesions and computed tomography (CT)-guided transcutaneous sclerotherapy for the deeper cisterns with doxycycline.


CONCLUSIONS
The combination of CO2 laser treatment and sclerotherapy with doxycycline seems to present a treatment option for cutaneous and subcutaneous lymphangioma circumscriptum with rare side effects.
Wimmershoff
M B
MB
Department of Dermatology, University of Regensburg, Regensburg, Germany. monika.wimmershoff@klinik.uni-regensburg.de
Schreyer
A G
AG
Glaessl
A
A
Geissler
A
A
Hohenleutner
U
U
Feuerbach
S S
SS
Landthaler
M
M
D000328:Adult; D003131:Combined Modality Therapy; D004318:Doxycycline / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D053685:Laser Therapy; D008202:Lymphangioma / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D019339:Port-Wine Stain / Q000175:diagnosis / Q000628:therapy*; D015641:Radiography, Interventional; D012597:Sclerosing Solutions / Q000008:administration & dosage; D015911:Sclerotherapy; D012878:Skin Neoplasms / Q000175:diagnosis / Q000628:therapy*; D014057:Tomography, X-Ray Computed
D012597:Sclerosing Solutions; D004318:Doxycycline