title: [Severe iatrogenic airway obstruction due to lingual lymphangioma].
abstract: Lymphangioma of the tongue is a rare and benign tumour involving congenital and cystic abnormalities derived from lymphatic vessels. Treatment modalities include surgery and a large number of different intralesional injections of sclerosing agents. Presently, OK-432 (Picibanil(®)) is the preferred sclerosant and when administered intralesionally will result in inflammation, sclerosis, and cicatricial contraction of the lesion. We report a case of microcystic lymphangioma of the tongue in a 5-year-old boy treated with an intralesional injection of OK-432. In the immediate postoperative period, the patient suffered severe diffuse swelling, progressive upper airway obstruction with inspiratory stridor, and respiratory distress requiring emergency fiberoptic nasotracheal intubation. Although OK-432 injections are found to be safe and effective as a first line of treatment for lymphangiomas, local swelling with potentially life-threatening airway compromise should be anticipated, especially when treating lesions near the upper airway.
authors.affiliation: Unité de soins intensifs pédiatriques, unité de gestion clinique de pédiatrie, hôpital universitaire Puerta del Mar, Avenida Ana de Viya n(o) 21, 11010, Cádiz, Espagne. cucusegui@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Segado Arenas
authors.forename: J-C
authors.initials: JC
authors.lastname: Flores González
authors.forename: F
authors.initials: F
authors.lastname: Rubio Quiñones
authors.forename: S
authors.initials: S
authors.lastname: Quintero Otero
authors.forename: A
authors.initials: A
authors.lastname: Hernández González
authors.forename: S
authors.initials: S
authors.lastname: Pantoja Rosso
mesh_terms: D000402:Airway Obstruction / Q000209:etiology* / Q000601:surgery / Q000628:therapy*; D002675:Child, Preschool; D006801:Humans; D015552:Injections, Intralesional; D007442:Intubation, Intratracheal; D018191:Lymphangioma, Cystic / Q000150:complications* / Q000188:drug therapy; D008297:Male; D010844:Picibanil / Q000008:administration & dosage / Q000009:adverse effects*; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000009:adverse effects*; D014062:Tongue Neoplasms / Q000150:complications* / Q000188:drug therapy; D014139:Tracheostomy; D016896:Treatment Outcome
chemical_list: D012597:Sclerosing Solutions; D010844:Picibanil