Long-term results of sclerotherapy for cervical-thoracic-mediastinal lymphatic and venous malformations: A case report.

Abstract

Cervical-thoracic-mediastinal LVMs in infants is rare, and very difficult to be cured because of life-threatening risk and recurrence. An infant with cervical-thoracic-mediastinal LVMs was treated in our department. Left neck was thick at birth, usually depressed, lazy and inactive. He showed dyspnea after about 3 min of automatic activity, with increased wheezing and open-mouth breathing, squatting after walking no more than 6 steps. There were masses and bulges in the left submandibular area and the left neck. The left cervical root and left clavicle were full. LVMs was diagnosed, and treated by sclerotherapy with bleomycin and triamcinolone acetonidein in a phased and step-by-step manner. The thoracic LVMs and mediastinal LVMs were cannulated under general anesthesia B-ultrasound guidance with an indwelling catheter; drugs were administered via the catheter. After several sessions, the submandibular LVMs and cervical LVMs were completely regressed, the thoracic LVMs and mediastinal LVMs were approximately 95 % regressed. Follow-up of 11 years, there was no recurrence; the lungs, thoraxes, and spines were well developed and free to move. Surgical resection of thoracic-mediastinal LVMs has high life-threatening risk, especially in children, and can't remove all of the LVMs. Comparing with surgical resection, sclerotherapy has the advantages of minimally invasive, low risk, conveniently repeated treatment, obvious curative effect. Therefore, cervical-thoracic-mediastinal LVM in infants can be effectively cured by sclerotherapy; the sclerotherapy has no obvious side effect on the development.