polidocanol and Lymphangioma

Topics: Humans; Lymphangioma; Lymphangioma, Cystic; Lymphatic Abnormalities; Polidocanol; Retrospective Studies; Sclerosing Solutions; Sclerotherapy; Treatment Outcome

Topics: Female; Humans; Lymphangioma; Polidocanol; Sclerotherapy; Vascular Diseases; Vulva; Vulvar Neoplasms

Head and neck lymphatic malformation is a rare benign tumor, mainly affecting children under 1 year of age. Total resection is often difficult, and recurrence is frequent. Functional and esthetic sequelae are a major issue.. A single-center retrospective study recruited patients with head and neck lymphatic malformation managed surgically, with or without associated sclerosis by alcohol, bleomycin or aetoxisclerol, between January 1, 2004 and December 31, 2013. Local control, recurrence and complications rates were analyzed, as were swallowing disorder, tracheostomy and impaired phonation.. Twenty-three patients, with a mean age of 15.80 years, were included. Location was suprahyoid in 17 cases (73.91%) and infrahyoid in 6 (26.09%). There were 11 macrocysts (47.82%), 2 microcysts (8.70%) and 10 mixed lesions (43.48%). Three patients showed spontaneous resolution; 12 patients (52.17%) underwent a single surgical procedure, 2 (8.7%) multiple procedures, 2 (8.7%) 1 surgical procedure and 1 sclerosis, 2 (8.7%) 1 surgical procedure and multiple scleroses, and 2 (8.7%) multiple procedures and multiple scleroses. The local control rate was 69.56%. There were 8 recurrences (34.78%), all in suprahyoid microcystic or mixed lesions. There were 2 complications (8.7%): 1 severe upper cervical edema following sclerosis of the floor of the mouth, and 1 postsurgical palsy of the marginal mandibular branch of the facial nerve. In 1 case (4.35%), a nasogastric tube was required for 6 days, without tracheostomy.. Recurrence was frequent, with non-negligible functional and esthetic impact, especially in case of suprahyoid and microcystic lesion.

Topics: Adolescent; Adult; Alcohols; Bleomycin; Child; Child, Preschool; Deglutition Disorders; Dysphonia; Dyspnea; Head and Neck Neoplasms; Humans; Infant; Infant, Newborn; Lymphangioma; Middle Aged; Polidocanol; Polyethylene Glycols; Recurrence; Retrospective Studies; Sclerosing Solutions; Sclerotherapy; Young Adult

Therapeutic interventions for microcystic lymphatic malformation (MLM), including surgical resection, have historically been difficult and frustrating because of a high recurrence rate due to multifocal lesions and failure to address the deeper component and excessive morbidity associated with excision of extensive lesions.. This study represents a retrospective analysis of response to treatment of 14 consecutive patients with MLM. The first four patients were treated with sclerotherapy alone using 3% polidocanol. The next 10 patients were treated with the combination technique of radiofrequency ablation (RFA) and sclerotherapy. The sessions were repeated at monthly intervals until complete clearance.. Nine of 10 patients who were treated with the combination technique achieved near-complete clearance. There were minimal intra- and postoperative sequelae. The patients treated with the combination technique also achieved faster results.. RFA ablates the lesions and achieves hemostasis while the sclerosant injected in and around the lesion reaches the deeper vascular lesions, preventing recurrence. The minimally invasive combination technique of RFA with sclerotherapy is a modality that can be used in the treatment of extensive microcystic malformations where surgical excision would lead to extensive scarring.

Topics: Adolescent; Adult; Catheter Ablation; Child; Child, Preschool; Combined Modality Therapy; Female; Humans; Lymphangioma; Male; Polidocanol; Polyethylene Glycols; Retrospective Studies; Sclerosing Solutions; Sclerotherapy; Young Adult

The aim of this prospective study was to assess the safety and efficacy of sonographically guided percutaneous injection of 1% polidocanol for sclerosis of peripheral vascular malformations.. Patients with vascular malformations of soft tissues were invited to enroll in the study. Gray-scale and color Doppler sonography were performed to determine the texture, margins, and size of the lesions and to determine whether high-velocity blood flow was present. Using real-time sonographic guidance, lesions were punctured with a 20/21-gauge spinal needle. When possible, venous return was occluded before injection. For each injection, 1-6 ml of 1% polidocanol was injected into 1 or more sites within the lesion. The sclerosing agent was not aspirated after injection. Repeat radiography was performed 1 month after each injection session. The procedure was repeated if the patient did not have a complete response, defined as an 80% or greater decrease in the volume of the lesion or resolution of the presenting symptoms.. Of the 15 patients enrolled, 9 had venous malformations, 3 had lymphangiomas, 1 had a recurrent aneurysmal bone cyst, 1 had a venous pseudoaneurysm, and 1 had an arteriovenous malformation of the pinna. Each patient received 1-20 injections of 1% polidocanol (mean +/- standard deviation, 3.3 +/- 4.8 injections). This treatment resulted in a complete response of 7 venous malformations, 3 lymphangiomas, and the arteriovenous malformation and partial response of 2 venous malformations, the recurrent aneurysmal bone cyst, and the venous pseudoaneurysm. Only minor complications occurred.. Sonographically guided percutaneous injection of 1% polidocanol for sclerosis of peripheral vascular lesions is simple, effective, and safe. This technique is especially effective in cases of soft tissue venous malformation and lymphangioma.

Topics: Adolescent; Adult; Arteriovenous Malformations; Child; Extremities; Humans; Injections, Intralesional; Lymphangioma; Polidocanol; Polyethylene Glycols; Prospective Studies; Sclerosing Solutions; Sclerotherapy; Ultrasonography, Doppler, Color; Ultrasonography, Interventional; Veins

Lymphangioma is a benign developmental anomaly of the lymphatic system located in about 40% of cases in the neck and usually completely resectable. In some cases it invades adjacent structures such as the larynx, pharynx, or tongue. In such cases it is almost impossible to resect completely, as this would endanger vital structures. We describe a baby born with a huge cervical lymphangioma which invaded the tongue, larynx, pharynx and other cervical structures. He was treated with bleomycin and aethoxysklerol. The sclerotherapy shrank the lymphangioma considerably and it became resectable. At 2 years of age the cosmetic result is good and vital function, such as swallowing and facial expression, are preserved.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Combined Modality Therapy; Head and Neck Neoplasms; Humans; Infant; Lymphangioma; Male; Neck; Neoplasm Invasiveness; Polidocanol; Polyethylene Glycols; Sclerotherapy; Treatment Outcome