picibanil and Facial-Neoplasms

Picibanil (OK-432) is a sclerosing agent derived from a low-virulence strain of Streptococcus pyogenes that induces regression of macrocystic lymphangiomas. This report describes a prospective, nonrandomized trial to evaluate the efficacy of Picibanil in the treatment of 13 affected children ranging in age from 1 to 94 months. On average, 4.1 fluoroscopically guided intracystic injections were performed per child, with an average total dose of 0.56 mg of Picibanil. As judged by physical examination and radiographic studies, 5 children (42%) showed a complete or substantial response, and 2 children (16%) showed an intermediate response. No response was seen in 5 children (42%), 2 of whom had massive craniofacial lymphangioma. Factors that contribute to failure with Picibanil sclerotherapy are the presence of a significant microcystic component to the lesion, massive craniofacial involvement, and previous surgical resection. Macrocystic lymphangiomas of the infratemporal fossa or cervical area have the best response to therapy.

Topics: Adolescent; Antineoplastic Agents; Child; Child, Preschool; Facial Neoplasms; Female; Follow-Up Studies; Humans; Infant; Injections, Intralesional; Lymphangioma; Magnetic Resonance Imaging; Male; Otorhinolaryngologic Neoplasms; Picibanil; Prospective Studies; Sclerotherapy; Treatment Outcome

Lymphangiomas are a common form of vascular malformation of the lymphatic vessels, mainly in the head and neck region. Most cases are progressive evolution and require a multidisciplinary approach. Currently, the first therapeutic option is sclerotherapy, leaving surgery for the treatment of remaining lesions.. To present a case of facial lymphatic malformation (LM) treated with sclerotherapy, surgery and orthodontics in a 15-year follow up.. A one-year-old female patient who consulted health professionals due to a progressive volume increase of the soft parts of her right cheek. The imaging study confirmed the diagnosis of microcystic lymphatic malformation. It was managed with OK-432 sclerotherapy and Bleomycin. At 2 years of age, the patient response was considered adequate; an intralesional submandibular surgical excision was then performed, with partial resection of the lesion. The biopsy confirmed the diagnosis of microcystic LM. Six months after, a re-resection was planned using the same approach and removing the remaining lesion, with favorable development until the age of 9 years when the patient required surgery and orthodontic management due to intraoral recurrence. No major developments until the age of 13 when a new orthodontic surgery and handling are planned to perform right oral commissure suspension.. LM management by sclerotherapy, surgery, and orthodontics has shown the advantages of a multidisciplinary long-term treatment in this case.

Topics: Adolescent; Bleomycin; Child; Child, Preschool; Facial Neoplasms; Female; Follow-Up Studies; Humans; Infant; Lymphangioma; Lymphatic Abnormalities; Orthodontics, Corrective; Picibanil; Sclerotherapy

Between April 1988 and July 1995, 11 children with lymphangioma were treated with intralesional OK-432 injection. In 7 patients it was the primary therapy and total shrinkage of the lesion was obtained in 5 of them. Two patients did not respond and the children underwent surgery. Following incomplete surgical removal or recurrence of the lymphangioma, intralesional OK-432 injection was used as secondary therapy in 4 patients. Total regression was observed in 2 cases and marked regression in the 2 others. No serious side-effects except fever lasting for 2-3 days and slight tenderness with swelling of the lymphangioma for 3-4 days after the injection was noted. Local inflammatory reaction did not cause any damage to the overlying skin and did not lead to scar formation. Depending on the size, location, and anatomical relationship of the airway, intralesional injections of the lymphangiomas were performed under general anaesthesia and the children were observed for 24 h. There was no recurrence after follow up periods ranging from 2 months to 7 years.. Intralesional injection OK-432 represents an alternative, safe and effective treatment for lymphangiomas. It can be used as the primary therapy, after partial surgical excision, or in recurrent lymphangiomas.

Topics: Antineoplastic Agents; Child; Child, Preschool; Facial Neoplasms; Female; Follow-Up Studies; Head and Neck Neoplasms; Humans; Infant; Lymphangioma; Neoplasm Recurrence, Local; Picibanil; Sclerosing Solutions; Thoracic Neoplasms

The authors present two cases of lymphangioma of the cervicofacial region, treated with a new investigational drug in North America, OK-432 (picibanil), a sclerosing agent intralesionally injected. Both patients had been treated surgically and had recurrence of the tumor. Intralesional injection of OK-432 without aspiration was employed for the first patient, and after aspiration in the second patient. A change in consistency of the tumor, manifested by softening, was followed by marked shrinkage. No complication either locally or systemically has occurred during the follow-up period (10 to 16 months). In both cases, satisfactory results were obtained, resulting in definite reduction in size and improvement in cosmetic appearance. The authors recommend OK-432 intralesional injection for surgically challenging lymphangioma. Their results support those of a recent Japanese study using OK-432 as sclerosing therapy for unresectable lymphangioma.

Topics: Adolescent; Adult; Antineoplastic Agents; Esthetics; Facial Neoplasms; Follow-Up Studies; Head and Neck Neoplasms; Humans; Injections, Intralesional; Lymphangioma; Lymphangioma, Cystic; Male; Neoplasm Recurrence, Local; Picibanil; Sclerosing Solutions; Sclerotherapy; Suction; Tongue Neoplasms