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Guidelines for the successful treatment of lymphangioma with OK-432
1Chris Hani Baragwanath Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Republic of South Africa. banieghbal@worldonline.co.za
Background/Purpose:
Cystic hygroma or lymphangioma (LA) is a disfiguring benign lesion commonly seen in the neck and face regions in children. Extensive neck/face resectional surgery is frequently performed for this condition, often with disappointing results. An attractive alternative to surgery is injection, sclerosing therapy. OK-432 injection therapy has been characterised as a novel treatment of LA since 1987. Since this first report, there have been a number of articles from different institutions reporting variable success rates with its use. This has resulted in uncertainty and confusion among physicians, surgeons and parents alike as to in whom, when, and how to treat patients with this modality.
Method:
A prospective study over a five-year period. Thirty-five patients were injected with this agent, 1 to 4 times, depending on response.
Result:
In patients with macrocystic LA, complete regression was achieved in 96 %. Patients with microcystic LA responded poorly or not at all.
Conclusion:
The anatomical appearance of the malformation on computerised tomography (or sonar) scan is crucial in determining the treatment strategy taken; macrocystic lesions respond almost universally to OK-432 injections, whereas patients with microcystic disease generally do not respond and should therefore not be injected with this agent.
