Efficacy of OK-432 sclerotherapy for different types of lymphangiomas: a review and meta-analysis

Abstract Objective This study aims to perform a meta-analysis to figure out the efficacy of OK-432 sclerotherapy between Macrocystic (MAC) lymphangiomas and Microcystic (MIC) lymphangiomas. Methods We conducted a systematic review and meta-analysis to clarify the relationship between OK-432 and lymphangiomas. PubMed and ISI Web of Science were searched from inception to May 2022. Joanna Briggs Institute (JBI) manual was used to evaluate the risk of bias. We calculated pooled Relative Risks (RR) and 95% Confidence Interval (95% CI) using random effects model to evaluate the relations between OK-432 and lymphangiomas. Results A total of 11 studies (including 352 cases) about OK-432 sclerotherapy for lymphangioma were included in the current meta-analyses. The results suggested that the efficacy of OK-432 was significantly in MAC lesions than in MIC (RR = 1.51, 95% CI 1.298-1.764), with significant moderate degrees of heterogeneity among 11 studies (I2 = 51.2%, p = 0.025). Subgroup analyses suggested that there was significant association in both retrospective studies (RR = 1.26, 95% CI 1.03-1.53) and classification (by 1 cm) (RR = 1.37, 95% CI 1.04-1.80) were associated with the efficacy of OK-432. Conclusion To our knowledge, our study represents the first meta-analysis examining the efficacy of OK-432 in the treatment of different types of LMs. However, the regional differences and the age differences of the subjects are the main limitations of this study and should be avoided in further research. Our results suggested that OK-432 sclerotherapy for macrocystic lymphangiomas was more effective.

Diagnóstico y manejo de lesiones vasculares en cabeza y cuello de pacientes pediátricos de la Fundación Hospital de la Misericordia, período 2012­2019 / Diagnose and care of head and neck vascular lesions in pediatric patients from Fundación Hospital de la Misericordia, from 2012­2019

Objetivo: identificar el manejo y respuesta a tratamientos que presentaron los pa-cientes pediátricos diagnosticados con hemangiomas y malformaciones vasculares en cabeza y cuello, que acudieron al servicio de Cirugía Oral y Maxilofacial de la Fundación Hospital de la Misericordia (HOMI) durante el período 2012­2019. Métodos: 11 p a c i e n-tes fueron atendidos en el servicio de cirugía oral y maxilofacial de la Fundación HOMI, entre enero de 2012 y noviembre de 2019, con diagnóstico de hemangioma y/o malfor-maciones vasculares. De estos, 9 fueron tratados con doxiciclina como agente esclero-sante. Resultados: se atendieron 5 pacientes masculinos y 6 femeninos con rango de edad entre los 8 meses y 13 años, con un promedio de 86,8 meses. La escleroterapia se realizó con doxiciclina en dosis de 100 mg disuelta en una ampolla de bicarbonato de sodio de 10 ml, inyectada en 5 pacientes con ecografía y en 4 por aspiración directa. De los 11 pacientes, 9 fueron tratados con escleroterapia; de estos 5 recibieron una sesión de escleroterapia, mientras que a los otros 4 se les realizó entre 2 y 3 sesiones. En 5 pacientes fue posible hacer seguimiento, ya que la atención depende de la autorización de la EPS. Conclusiones: la doxiciclina como agente esclerosante utilizado en lesiones vasculares ha demostrado ser un medicamento seguro, de bajo costo y efectivo como tratamiento inicial de hemangiomas y malformaciones vasculares en la cara. El número de aplicaciones depende del tipo de lesión a tratar.

Objective: Identify the treatment provided to patients with hemangioma and vascular deformities diagnosis .in head and neck who resorted to Oral and Maxillofacial service in Fundación Hospital de la Misericordia (HOMI) from 2012-2019 and the outcome of this treatments. Methods: Eleven (11) patients were admitted and treated by the surgical and maxillofacial team in "Fundación Hospital la Misericordia HOMI", between January 2012 and November 2019 with the hemangioma and vascular deformities diagnosis. Nine (9) of them were treated using doxycycline as a sclerosing agent. Results: Out of the eleven (11) patients, five (5) were males and the other six (6) were females, with an age range going from 8 months, up to 13 years, for an average of 86,8 months. A sclerotherapy was performed using doxycycline, with a dosage of 100 mg dissolved in a syringe with 10 mL of sodium bicarbonate on five (5) patients with ultrasound, and four (4) with direct aspiration. Out of the eleven (11) patients, five (5) received one sclerotherapy session the remaining four (4) received 2 or 3 sessions. In five (5) of the patients it was possible to complete follow-ups since the attention depends on their healthcare provider. Conclusions: Doxycycline as a sclerosing agent used in vascular lesions has demonstrated to be a safe treatment, with low cost, and effective as an initial treatment for hemangiomas and vascular deformities on the face. The number of sessions depend on the lesion that is going to be treated.

Fetal thoraco-abdominal lymphangioma: a case report

Lymphangiomas are rare congenital malformations of the lymphatic system. Authors present a case with giant, septated, axillary thoraco-abdominal lymphangioma. Diagnosis was made at 19 weeks’ gestation by antenatal ultrasonography. The case underwent prenatal expectation treatment.

Cervical Cystic Hygroma in an Adult

Cystic hygroma are benign tumors in the early childhood mainly manifesting in the head and neck region ..Cystic hygromas manifesting in elderly patients have not been reported in the literature so for. We report a rare presentation of cervical cystic hygroma in an adult male (58 yrs.), with sudden appearance and rapid progression to a relatively big size (10 cm x 12 cm) invloving superior mediastinum within a span of six months, giving a clue to malignant cystic pathology. Investigations proved the diagnosis of cystic hygroma. Transcervical excision was achieved with the help of cardiothoracic surgeons. The management of the cystic hygroma is being discussed.

A Case of Lymphangiomas(So-called Combined Venous Lymphatic Malformation) Resulting in Orbital Abscess

Orbital lymphangiomas are benign vascular hamartomas that may be found in the conjunctiva, the eyelids, the orbit, or elsewhere in the head and neck region. Deep lymphangiomatous lesions are classically characterized by acute onset of a fulminant proptosis resulting from spontaneous hemorrhage within the orbit. Complete surgical excision is often difficult because of the infiltrative nature of the tumor.We report one case of lymphangiomas considered to be associated with cavernous hemangioma which could not be removed completely by several surgical excisions and was exenterated because of orbital abscess of unknown origin and septic condition.