Abstract

The aim of this study is to investigate the optimal treatment strategy for lymphangioma by analyzing the results of primary excision and sclerotherapy with bleomycin.

Retrospective analysis of patients with lymphangiomas treated at our institution between 2000-2010 was performed. Data related to age, and gender of the patients, localization, and radiological type of lymphomas, treatment methods and their outcomes were reviewed.

Twenty-nine invasive attempts (16 excisions, 13 sclerotherapies) were performed on 22 patients (17M, 5F). Mean age of the patients was 2,1±2,9 years. Lesions were localized on head-neck (9), axillary (6), trunk (6) and retroperitoneal regions (1). Lymphangiomas were classified as macrocystic, microcystic and cavernous types.. Treatment success was evaluated based on decrease in mass size as “poor response” (<75 %), and “good response” (75-100 %). Fourteen patients treated with primary surgical excision had achieved good (9) (64 %) and poor (5) responses. Additional sclerotherapy procedures were required in 5 patients after excision and treated successfully. Eight patients treated with primary sclerotherapy had good (6) (75 %) and poor (2) response rates, and 2 additional surgical excisions were necessitated. Patients who needed additional therapy after sclerotherapy had microcystic lesions. No major complications were seen in both groups. Mean follow-up period was 5 years (3 months-10 years). “Good” surgical success was proved at all patients.

Sclerotherapy and/or primary excision could be performed in the treatment of lymphangioma Achievement of surgical success is depended on appropriate patient choice. As a general approach, sclerotherapy must be preferred primarily for macrocystic lesions and excision for microcystic lesions.