In this article, we will discuss the treatment options available for lymphangioma. Sclerotherapy can be a good option for these patients. This procedure involves injection of a small amount of sclerosant into the affected area. Bleomycin, Doxycycline, or OK-432 are among the drugs that are available for this purpose.
OK-432
In this case, OK-432 sclerotherapy was used to treat a patient with a sublingual ranula, a type of lymphangioma, in the right sublingual space. The patient’s initial contrast-enhanced CT scan revealed a large, plunging ranula, which had spread to the upper neck. The patient underwent five injections of OK-432. The lesions disappeared for 1-2 months, but the ranula recurred two months later.
OK-432 was effective in treating the lesions in nine out of ten patients, with the most favorable results occurring after one to three injections. Two of these patients had microcystic lesions, and the remaining seven cases had more conventional lesions, including one large hemangioma. OK-432 was administered three times to the cyst, and the patient continued to receive OK-432 injections at three and four months after the initial injections.
OK-432 sclerotherapy is approved by the FDA for the treatment of lymphangiomas. It is effective in the treatment of cystic lymphangioma and is a viable treatment option for patients with recurrent lymphangiomas. The procedure has also been studied in a paediatric population and has shown promising results.
OK-432 sclerotherapy is a biocompatible treatment that induces an inflammatory response in lymphatic cells. It is approved for use in children with recurrent lymphangioma. OK-432 is a sclerosant that contains Streptococcus pyogenes strains that are treated with benzathine penicillin. It stimulates the proliferation of lymphatic endothelial cells and inhibits lymphatic channels. OK-432 is typically administered in doses of 20 mL per application, but some studies have reported higher dosages.
OK-432 is an alternative treatment for congenital cystic lymphangioma, and its effectiveness has been confirmed in a clinical trial. The treatment was performed on 30 patients at 13 US tertiary care referral centers. The median follow-up was 2.5 months, and the range was 0.7 to 56.7 months.
The safety of OK-432 is unknown. This sclerosant is an intralesional sclerosant, which can cause local pain and edema. Although OK-432 has positive results in clinical trials, its use in children is controversial.
OK-432 sclerotherapy is an alternative to surgery, which may be risky for patients. This treatment involves the injection of OK-432 solution into the inflamed area using a needle. It is safe and results in a substantial reduction in cyst size. It can be used as a primary treatment or as a step before surgery.
Bleomycin
Bleomycin is a powerful anti-tumor agent. It is generally administered via sclerotherapy. This procedure is generally accompanied by a contrast agent, which is a liquid used in contrast to the bleomycin. The total dose is between two and four milligrams per treatment session. The addition of dexamethasone to the mixture helps attenuate local responses after the procedure and dilutes the bleomycin concentration. The dose of bleomycin used is dependent on the type and size of the lesion and its response to sclerotherapy.
Bleomycin is generally safe and effective in the treatment of lymphangioma in children. However, there have been some reports of complications. A recent study included 24 children with lymphangioma and showed that 63% of them achieved complete resolution of their lesions. Only two patients developed an abscess at the site of the injection.
In a recent study, researchers used a new method called bleomycin sclerotherapy in 13 children with lymphangiomas. The participants were ages 15 days to 10 years. The lesions were located in the neck, scapular region, and floor of the mouth. In eight of the patients, bleomycin was effective and only three had a poor response. In these patients, 3 injections were required for the full response.
Several trials have been conducted using bleomycin. In one study, bleomycin was administered intralesionally to a patient’s lymphangioma. In a similar study, bleomycin and radiofrequency ablation were combined in a single treatment session.
This approach to treating lymphangiomas has recently become popular. Although it is not a cure, bleomycin sclerotherapy has been proven to be a highly effective alternative to surgery. It reduces the size of the lymphangioma while preserving the neurovascular integrity.
Bleomycin is also used for recurrent microcystic lymphatic malformations. It is also used to treat post-inflammatory pigmentation. Sclerotherapy can help patients with recurrent lymphangiomas that are undergoing surgery.
Bleomycin is available commercially as a dried powder. Each vial contains fifteen international units (IUs), which are equivalent to one milligram. The recommended dosage is 0.5 mg/kg body weight, with the maximum dose of 15 mg. A 23-gauge needle is used to inject the solution. Multiple punctures are typically required.
Bleomycin in sclerotherapies for lymphangioma has a range of potential side effects. It can cause pulmonary toxicity. However, this is rare and is not a life-threatening complication. Bleomycin is often combined with lignocaine.
Bleomycin is an effective treatment for lymphatic malformations. It can be used as a standalone treatment or as part of a multimodal therapy. The patient is given four to eight injections in one session. The total number of injections varies depending on the size and location of the lesion.
Patients were admitted to the hospital for 24 hours after the procedure to be monitored for immediate and delayed complications. After two to four weeks, patients were followed up to assess whether there were any residual lesions. If the cysts were larger than 1 cm in diameter, a repeat procedure was performed.
Doxycycline
Percutaneous sclerotherapy with Doxycycline for the palliative treatment of unresectable lymphangiomas has been reported to be safe and effective in a small number of cases. These findings are consistent with early clinical experience. In a study, a patient with an inoperable, unresectable lymphangioma underwent sclerotherapy using doxycycline as the sclerosant.
Sclerotherapy with Doxycycline has also been used for the treatment of cervical cystic hygromas. This treatment is a safe and effective alternative to surgical excision. However, this procedure is only effective when combined with a proper diagnostic workup. Moreover, the procedure is not suitable in all countries, so it is important to consider your local hospital’s guidelines before undergoing this procedure.
In a retrospective study, doxycycline sclerotherapy was used to treat 11 pediatric patients with head and neck lymphatic malformations. The efficacy of this treatment was assessed through radiographic imaging and physical examination. A radiographic response of greater than 50% was considered successful.
The efficacy of sclerotherapy with Doxycycline has been reported in several studies. It was initially used for pleurodesis of malignant effusions. Since then, it has been used to treat cystic lymphangiomas. It was first reported to be effective by Molitch et al. Then, in another study, Burrows and Saxena treated 41 patients with doxycycline sclerotherapy. Overall, the patients achieved complete or partial clinical remission.
The study found that doxycycline is a safe and effective sclerosant for treating LMs. However, more follow-up is needed to determine long-term outcomes and assess the risk of lesion recurrence.
Doxycycline is a widely available and inexpensive antibiotic. It is a potent angiogenesis inhibitor and suppresses the proliferation of lymphocytes. In addition, doxycycline inhibits matrix metalloproteinases, a key component in cell proliferation.
Occult lymphangiomas are common in children and are treated with sclerotherapy. It is a minimally invasive treatment that may save patients from surgery. However, it is important to follow the instructions of your physician and other healthcare providers before undergoing sclerotherapy.