Liposuction-Like Sclerotherapy Technique for Microcystic Lymphatic Malformation

Huaijie Wang,Chong Xie,Weilong Lin,Weijia Yang,Zhengtuan Guo,Jinbang Zhou

doi:10.7759/cureus.22795

Abstract

BackgroundThe treatment for microcystic lymphatic malformation (LM) remains challenging. We describe the liposuction-like sclerotherapy technique, a new treatment for extensive microcystic LM.MethodsLM data was retrospectively reviewed. This study included patients with a microcystic LM component treated by liposuction-like technique with bleomycin sclerotherapy.ResultsBetween June 2016 and October 2019, 39 consecutive patients (male/female ratio: 21:18; mean age, 33.6 months; range: 5 months to 15 years) with microcystic LM were treated by liposuction-like sclerotherapy (LS-LS) technique. Fifty-six sessions of LS-LS were performed (mean of 1.44 sessions per patient; range: one to four sessions). Follow-up ranged 6-30 months (mean of 21 months). We observed no major complications. Transient minor complications included: postoperative noninfectious fever, vomiting, temporary skin edema, pigmentation, mild local depressions, and/or irregularities, and a small hyperpigmented scar at the incision. No postoperative infection, skin ulcer, or necrosis occurred. The patients’ symptoms were successfully resolved or stable. A sub-complete response and partial response were observed for 26 (76%) and 13 patients (33%), respectively.ConclusionThe LS-LS technique for microcystic LMs is safe, feasible, and effective. This technique is an effective intervention with which it is possible to manage and potentially cure microcystic LM clinically.

Highlights

Lymphatic malformations (LMs) are congenital lymphatic anomalies, which may result from abnormal lymphatics development, often with underlying somatic PIK3CA mutation [1]
Between June 2016 and October 2019, 39 consecutive patients with microcystic LM were treated by liposuction-like sclerotherapy (LS-LS) technique
Encouraging results were obtained in microcystic LMs with intralesional bleomycin sclerotherapy [4-7]

Summary

Introduction

Lymphatic malformations (LMs) are congenital lymphatic anomalies, which may result from abnormal lymphatics development, often with underlying somatic PIK3CA mutation [1]. LMs can be solitary or multifocal and can be classified into macrocystic ( 1-2 cm), microcystic ( 1 cm), or mixed cystic lesions [2]. Sclerotherapy is the mainstay treatment for macrocystic LMs but has a poor response in microcystic and mixed cystic lesions [3-5]. The microcystic lesion typically consists of multiple small cysts ( 1 cm), in which traditional sclerotherapy and direct injection are less effective due to the small size of the lumen. In cases with extensive microcystic component, it is difficult to obtain successful results despite multiple sclerotherapy sessions with traditional techniques. We have reported a new treatment, liposuction-like sclerotherapy technique (LS-LS) that successfully managed superficial LM in some cases [8]. We describe the liposuction-like sclerotherapy technique, a new treatment for extensive microcystic LM

Methods

Results

Conclusion