The Treatment of Lymphangiomas With Bleomycin in Childhood: a Retrospective Observational Study

Abstract

Introduction: Lymphangioma is defined as the congenital malformation of the lymphatic system. According to morphologicalclassifications, there are macrocystic, microcystic and mix types. Treatments vary from one clinic to another given thatthere are no commonly accepted guidelines. This study aims to present the results of ultrasonography-guided intralesionalbleomycin treatment of lymphangioma.Methods: Retrospective evaluation was conducted on 20 patients with lymphangioma who were treated with intralesionalbleomycin. Under local anesthetic and aseptic conditions, 0.4-0.6 mg per kg bodyweight of bleomycin was injected underultrasonography guidance. The response was graded as “excellent response” (>90% reduction), “good response” (>50% reductionin size) and “poor response” (<50% reduction or no change in size).Results: The 20 cases comprised eleven female and nine male patients with a mean age of 3.1 years. The lymphangioma waslocated on the neck in eight cases, on the trunk in seven cases, on the axillary region in two cases, the mass extended fromthe neck to the mediastinum and retropharynx in one case. Also, it was on the anterior surface of the thigh in one case andon the anterior surface of the leg in one patient. Excellent response was seen in 50% of the patients, a good response in 40%and a poor response in one patient.Discussion and Conclusion: Bleomycin injection is very effective for the treatment for macrocystic and mixed type lymphangiomaof the neck and on any other surface area of the body. It is an appropriate treatment choice for cases that havepreviously undergone surgery and then show recurrence or incomplete resection.