Efficacy of bleomycin for non-operative treatment of cervical lymphangioma in University of Ilorin Teaching Hospital, Nigeria

Background: Lymphangiomas are the developmental defects of the lymphatic channels, and they are most commonly found in the head and neck regions. Late presentation, rejection of surgery, and traditional scarification result in fatal complications. Surgical excision often thought to give immediate relief and aesthetic results is associated with damage to contiguous structures and recurrence, hence, the need for less invasive treatment modality. Objective: To assess the effectiveness of bleomycin sclerotherapy of cervical lymphangiomas. Materials and Methods: This is a prospective study of patients with cervical lymphangioma treated with sclerosant injection between January 2008 and December 2016. Preinjection ultrasound scan and initial ultrasound-guided aspiration of the fluid in the swelling (which many times is multiloculated) using a 20G cannula into a 10 ml syringe were performed. The cannula tip is retained in the space and intralesional injection of double-diluted bleomycin 0.5 i.u./kg body weight was given as outpatient at 2­4-weekly interval. Postinjection events were documented. The clinical assessment of the pre- and postinjection of sclerosant was performed. Result: A total of 23 patients were recruited, and six were females and 17 were males. All swellings were noticed at birth but median time at presentation was 17 days. All patients but one (95.8%) had complete clinical resolution after 1­4 courses of sclerotherapy for 4­16 weeks. Only one patient had residual nodule that required surgical excision. Redundant skin and hyperpigmentation from skin wrinkle were the early effects noticed in three patients; however, these were cosmetically acceptable to the parents. No recurrence was recorded. Conclusion: The treatment of cervical lymphangiomas with intralesional bleomycin injection is shown to be effective. It is safe and associated with no complication. This treatment modality and outcome was found to be acceptable to the parents of these children

Les lymphangiomes : etude retrospective de 12 cas a Yaounde (Cameroun)

Objectif : Rechercher les donnees preliminaires sur les lymphangiomes au Cameroun; leurs topographies ainsi que leurs formes histologiques dans le but d'ameliorer le diagnostic et les modalitestherapeutiques de ces lesions. Materiel et methode : Il s'agit d'une etude retrospective; observationnelle et descriptive.Les patients ayant presente des lymphangiomes documentes par un rapport anatomopathologique ont ete recrutes consecutivement dans tous les laboratoires d'anatomie pathologique du Cameroun sur une periode de 06 ans; de 2004 a 2009. Les coupes histologiques colorees a l' hematoxyline-eosine ont ete revues pour confirmation diagnostique de differents types. Resultats : Douze cas ont ete recrutes. La moitie de ces cas provenait des malades originaires de la region de l'ouest du Cameroun. Le lymphangiome touchait le plus souvent l'enfant age de 1 a 5 ans avec predominance du type hygrome kystique. Les localisations les plus courantes etaient axillaires; cervicales et viscerales. Conclusion : Le lymphangiome constitueun desdiagnostics differentiels important de toute masse survenant chez les patients; en particulier chez les enfants ages de 1 a 5 ans.L'anatomie pathologique est d'une aide dans le diagnostic et la typisation

Anaesthetic Management for Surgical Relief of Neonatal Airway Obstruction Caused by a Cystic Hygroma

Background: Cystic hygroma is a rare congenital malformation of the lymphatic system which may cause neonatal airway obstruction. Surgical excision of this tumour is associated with high morbidity and mortality. Aim: To report the anaesthetic management for a successful excision of a cystic hygroma in a neonate. Case Report: A two-day-old female presented with history of an anterior neck swelling; tachypnoea and dyspnoea ; noticed at birth. There was associated stridor and subcostal recession. A diagnosis of cystic hygroma with upper airway obstruction was made. Tumour excision was done under endotracheal general anaesthesia. An intraoperative tracheostomy was carried out. Cyanosis occurred frequently within first 24 hours postoperatively while in the special care baby unit (SCBU) and was relieved by intermittent suction of the tracheostomy tube. Patient was weaned off the tracheostomy tube on the 30th post-operative day and discharged home two days later. She was subsequently followed up at the paediatric surgery outpatient clinic. Conclusion: Anaesthetic management for excision of a cystic hygroma in a neonate is by no means easy. It can be successful if the airway remains patent; ventilation is adequate; normothermia and optimal replacement of body fluid losses are ensured

Aspects histopathologiques de tumeurs vasculaires cervico faciales en orl au CNHU de Cotonou (1985-2005) / Histopathological aspects of cervico-facial vascular tumors in ENT at the CNHU of Cotonou (1985-2005)

Dans une étude rétrospective entre le 1er janvier 1985 et le 30 juin 2005, vingt six (26) cas de tumeurs vasculaires avec confirmation histopathologique ont été recensées en ORL au CNHU de Cotonou. Les sujets de 0 à 20 ans ont constitué 57,6% de la série. La prédominance a été masculine 57,6%. Les motifs de consultation les plus enregistrés ont été la tuméfaction de la face 53,9% et celle du cou 30,9%. L'histopathologie a révélé 88,5% de tumeurs bénignes et 11,6% de tumeurs malignes. Les principales étiologies retrouvées ont été : l'hémangiome 65,3%, le lymphangiome 19,2% et l'hémangio-endothéliome malin 7,6%.

Apport de l'anatomie pathologique dans le diagnostic des tumeurs vasculaires cervico-faciales au C.N.H.U. de Cotonou

Sur une periode de 14 ans; les auteurs ont collige 43 cas de tumeurs vasculaires au niveau du cou et de la face. De leur etude ressortent les conclusions suivantes: sur le plan diagnostique le tableau clinique est evocateur mais la clef du diagnostic est apportee par l'examen anatomopathologique; la chirurgie d'exerese; parfois precedee d'infiltration locale des produits sclerosants a ete l'unique arme therapeutique compte tenu des ressources therapeutiques limitees; enfin les resultats therapeutiques ont ete bons dans l'ensemble (83;7 pour cent de bons resultats)

Lymphagiome kystique cervical: apport de l'echographie et de la tomodensitometrie: a propos d'un cas. [Lette]

Les auteurs; a partir d'un cas de lymphagiome kystique cervical; signalent l'apport de l'imagerie medicale; surtout de l'echographie et la tomodensitometrie; dans le diagnostic de cette affection rare

Chilaiditi's syndrome in surgical practice. [case report]

Transients or persistent hepatodiaphragmic interposition of the colon or small intestine; so called chilaiditi's syndrome; is a frequent and general asymptomatic condition; known to all radiologists. All authors agree; the syndrome is commonest in elderly patient. The case reported here is that of 78-year-old man with a long history of abdominal pain; constipation; abdominal distension; loss of appetite; loss of weight and general weakness. Physical examination at admission revealed a cachetic man; dehydrated; with a soft; tympanic; distended abdomen. Routine chest and abdominal x-rays confirmed chilaiditi's syndrome