Definitive percutaneous treatment of lymphatic malformations of the trunk and extremities.
OBJECTIVE
The aim of this study is to investigate a new treatment regimen for macrocystic and microcystic lymphatic malformations (LMs) of the trunk and extremities.


METHODS
Sixteen patients (aged 2 months-22 years) underwent percutaneous treatment for LM of the trunk and extremities from 2002 to 2007. The LM involved the arm, leg, axilla, chest, abdomen, scrotum, and penis. Eleven patients underwent primary treatment of LM; 5 were treated for recurrence after prior operative resection. Macrocysts (>or=1 cm) were treated with dual-drug chemoablation (sequential intracystic sodium tetradecyl sulfate and ethanol); doxycycline was used for microcysts. Macrocysts and microcysts were treated after complete cyst aspiration using sonographic guidance. Twenty-four macrocysts and 103 microcysts were treated. The goal of treatment was complete cyst ablation documented by sonography or magnetic resonance imaging.


RESULTS
The mean number of treatments was 1.7 per patient; the mean number of treatments for macrocysts was 1.3 and for microcysts was 1.7. Ablation efficacy was 100% (127/127 cysts). Treatments included massive intraperitoneal cysts and cysts surrounding the adventitia of the brachial artery and brachial nerve. Infection occurred in 2 (13%) of 16 patients. No patient experienced postprocedural pain, skin necrosis, neuropathy, bowel obstruction, skin retraction, or myoglobinuria.


CONCLUSIONS
Percutaneous sclerotherapy provides effective treatment for macrocystic and microcystic LM as primary treatment or for recurrence after surgical resection.
Shiels
William E
WE
Department of Radiology, Nationwide Children's Hospital, The Ohio State University Medical Center, Columbus, OH 43205, USA. william.shiels@nationwidechildrens.org
Kenney
Brian D
BD
Caniano
Donna A
DA
Besner
Gail E
GE
D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005121:Extremities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D044148:Lymphatic Abnormalities / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods*; D012720:Severity of Illness Index; D013909:Thorax; D016896:Treatment Outcome; D014463:Ultrasonography
D012597:Sclerosing Solutions