Is intralesional injection of OK-432 effective in the treatment of lymphangioma in children?
BACKGROUND
Intralesional injection of OK-432 has been proposed as an effective treatment of lymphangioma. The aim of this study was to review our experience with OK-432 injection of lymphangioma and to identify factors associated with successful outcome.


METHODS
We made a case note review of 19 children who received OK-432 injection. Median duration of follow-up was 17 months.


RESULTS
Lesions were diagnosed antenatally in 4 children, at birth in 4 children, and between 1 month and 11 years in the remainder. Anatomic locations were head/neck in 14, axilla in 1, and multiple locations in 4. Median number of injections per child was 2 (range, 1 to 5). Disappearance of the lesion was achieved after OK-432 injection in 2 patients (11%) and a marked reduction in 5 (26%); all these lesions were in the head and neck. Lesions larger than 5 cm and those outside the head and neck region did not respond well to OK-432 injection. Fourteen children (74%) required surgical excision after injection. Complications of OK-432 injection included partial tracheal obstruction, fever, local inflammatory response, and abscess formation.


CONCLUSIONS
OK-432 injection was effective in approximately one third of children with lymphangioma. Lesions outside the head and neck and those larger than 5 cm are unlikely to respond to this therapy. Injection of lymphangioma surrounding the airways may be hazardous.
Hall
Nigel
N
Department of Paediatric Surgery, Institute of Child Health and Great Ormond Street Hospital for Children, London, UK.
Ade-Ajayi
Niyi
N
Brewis
Clive
C
Roebuck
Derek J
DJ
Kiely
Edward M
EM
Drake
David P
DP
Spitz
Lewis
L
Pierro
Agostino
A
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015552:Injections, Intralesional; D008202:Lymphangioma / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D010844:Picibanil / Q000008:administration & dosage*; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D010844:Picibanil