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Early Adjuvant Medication With the mTOR Inhibitor Sirolimus in a Preterm Neonate With Compressive Cystic Lymphatic
Marion Honnorat1, Loïc Viremouneix2,3, Sonia Ayari4
1Service de Réanimation Néonatale, HFME, Hospices Civils de Lyon, Bron, France.
Frontiers in Pediatrics
|August 28, 2020
Summary
Cystic lymphatic malformations in preterm infants can cause airway obstruction. Early sirolimus treatment combined with sclerotherapy offers a safe and effective management approach for neonates.
Area of Science:
- Medical science
- Pediatric medicine
- Neonatology
Background:
- Cystic lymphatic malformations arise from abnormal embryonic development of lymphatic structures.
- These malformations can lead to significant complications, including airway obstruction, particularly in neonates.
Observation:
- A preterm female infant (34 weeks gestation) presented with a large cervicofacial cystic lymphatic malformation.
- The malformation caused severe airway obstruction, necessitating prompt intervention.
Findings:
- The neonate received early administration of sirolimus, an mTOR inhibitor, from the first day of life.
- Treatment was combined with iterative sclerotherapy procedures.
- This combined approach demonstrated safety and efficacy in managing the condition.
Implications:
- Early sirolimus intervention is a viable and safe therapeutic option for preterm neonates with cystic lymphatic malformations.
- This case highlights the potential for improved outcomes in high-risk neonates with complex lymphatic anomalies.

