Treatment of lymphangioma in children: our experience of 128 cases.
OBJECTIVE
The aim of this study is to investigate the optimal treatment for lymphangioma in children by analyzing the effectiveness and complications of treatment modalities.


METHODS
We reviewed 128 patients with lymphangioma treated at our institution between 1979 and 2005. Periods of treatment were divided arbitrarily into 2 groups: period I, from 1979 to 1988 (n = 53); and period II, from 1989 to 2005 (n = 75). According to radiological appearance, patients were grouped into 4 types: single cystic (SI; n = 23), macrocystic (MA; n = 11), microcystic (MI; n = 69), and cavernous (CA; n = 25).


RESULTS
Sclerotherapy as primary treatment was performed in only 2 patients (3.8%) in period I using bleomycin but increased significantly in period II to 48 patients (64.0%) using OK-432 (P < .01). Nevertheless, primary surgical excision (69/78 patients, 88.5%) was significantly more successful than sclerotherapy (32/50, 64.0%) (P < .01). The following are the locations and types of lesions: head/neck (n = 69; SI, 11; MA, 5; MI, 42; CA, 11), trunk (n = 34; SI, 6; MA, 6; MI, 15; CA, 7), and extremities/other (n = 25; SI, 6; MI, 12; CA, 7). The effectiveness of sclerotherapy in SI, MA, MI, and CA types was 90.9%, 100%, 68.0%, and 10.0%, respectively. Seventeen patients (SI, 1; MI, 8; CA, 8) who received primary sclerotherapy required surgical excision with good outcome. Complications after primary surgical excision were more serious compared with sclerotherapy.


CONCLUSIONS
Sclerotherapy with OK-432 was not as effective as reported in the literature. We recommend OK-432 injection therapy alone for SI and MA types and surgical excision after pretreatment with OK-432 for MI and CA types.
Okazaki
Tadaharu
T
Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo 113-8421, Japan. okazakit@med.juntendo.ac.jp
Iwatani
Saori
S
Yanai
Toshihiro
T
Kobayashi
Hiroyuki
H
Kato
Yoshifumi
Y
Marusasa
Takashi
T
Lane
Geoffrey J
GJ
Yamataka
Atsuyuki
A
D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D006801:Humans; D007223:Infant; D008202:Lymphangioma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D010844:Picibanil / Q000627:therapeutic use*; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*; D013514:Surgical Procedures, Operative / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome
D012597:Sclerosing Solutions; D010844:Picibanil