Slcerotherapy with 98% ethanol for a neck lymphangioma: A case report

Abstract

IntroductionLymphangiomas, also known as cystic hygromas, are benign tumors commonly located in the head and neck of newborns. Their pathogenesis is still unknown. Traditionally, surgical excision has been the treatment of choice, but several authors have suggested non-surgical alternatives, such as medication and sclerotherapy. Case presentationA teenage male presented with an isolated slow-growing cystic mass on the right and posterior sides of the neck. He first noticed it 2 years before. There was no history of trauma or prior surgeries. He was in good health and had no significant medical history. By palpation he had a 10 cm × 12 cm non-tender mass with normal overlying skin. No lymphadenopathies were found. Ultrasound and contrast-enhanced computed tomography showed a large, well-defined, uniloculated cystic lesion in the right posterior cervical triangle, extending into the right deep cervical spaces, measuring 6.3 x 6.3 × 7.7 cm. These features were suggestive of a cervical cystic lymphangioma. Laboratory workup was normal. The mass was treated with by aspiration of the fluid (approximately 40 cc), followed by the injection of 98% ethanol. The ethanol was left dwelling for 2 min, was then aspirated, and the cavity washed through the same needle with normal saline. The procedure was done under anesthesia. The patient was discharged home on the second postoperative day. The mass regressed progressively and was almost clinically undetectable 3 months later. ConclusionSclerotherapy with ethanol 98% seems to be an efficient, safe, and cost-effective treatment for macrocystic lymphangiomas affecting the neck.