Our experience of bleomycin sclerotherapy for peripheral lymphangioma in children and review of the literature

Abstract

Objective: To assess the efficacy of intralesional bleomycin in peripheral lymphangioma in children.

Methodology: This prospective study was conducted at the Department of Pediatric Surgery at Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad from January 2005 to December 2009. Patients included in this study were only with peripheral lymphngioma, while those with visceral lesions or previously operated for lymphangiomas were excluded. Diagnostic tools for lymphangioma were physical examination and ultrasound. All patients had aspiration of lesion with 20-24 gauge needle and intralesional injection therapy with bleomycin with dosage of 0.5mg/kg body weight diluted in normal saline. The procedure was performed as out patients. Patients were followed up at four weeks interval for up to six months. Personal data, procedure, complications and follow up were recorded on pre-designed proforma.

Results: Total number of patients included in this study was 20, with13 males and 7 females. Reduction in size was noted in 75%. Excellent response was seen in 9 (45%) patients who had cystic lymphangioma, while 6(30%) patients showed good response and 5(25%) had poor response. Common site was neck (65%).Transient increase in size of lesion and cellulitis were observed in three patients and treated conservatively.

Conclusion: Intralesional bleomycin is excellent in cystic lymphangioma, while it had good response in mixed lymphangioma. We suggest bleomycin as a primary therapy in all varieties of lymphangiomas.