Management of Lymphatic Malformations

Lymphatic malformations (LMs) are rare congenital vascular anomalies commonly affecting the cervicofacial region and frequently associated with somatic PIK3CA mutations. According to the 2025 International Society for the Study of Vascular Anomalies guidelines, LMs are classified into isolated lesions, complex anomalies, and lymphedemas. Diagnosis relies on ultrasound, MRI, and magnetic resonance lymphangiography for anatomic and functional evaluation. Management has evolved from primarily surgical excision to a multidisciplinary, multimodal strategy. Sclerotherapy and sirolimus now play central therapeutic roles, while surgery remains important for reconstruction and deformity correction. Emerging techniques such as bleomycin electrosclerotherapy and laser therapy further enhance individualized treatment outcomes.