ABSTRACT
OBJECTIVE: Here, we describe our experience with different therapeutic modalities used to treat cystic lymphangiomas in children in our hospital, including single therapy with OK-432, bleomycin and surgery, and a combination of the three modalities. METHODS: We performed a retrospective, cross-sectional study including patients treated from 1998 to 2011. The effects on macrocystic lymphangiomas and adverse reactions were evaluated. Twenty-nine children with cystic lymphangiomas without any previous treatment were included. Under general anesthesia, patients given sclerosing agents underwent puncture of the lesion (guided by ultrasound when necessary) and complete aspiration of the intralesional liquid. The patients were evaluated with ultrasound and clinical examinations for a maximum follow-up time of 4 years. RESULTS: The proportions of patients considered cured after the first therapeutic approach were 44% in the surgery group, 29% in the bleomycin group and 31% in the OK-432 group. These proportions were not significantly different. Sequential treatment increased the rates of curative results to 71%, 74% and 44%, respectively, after the final treatment, which in our case was approximately 1.5 applications per patient. CONCLUSION: The results of this study indicate that most patients with cystic lymphangiomas do not show complete resolution after the initial therapy, regardless of whether the therapy is surgical or involves the use of sclerosing agents. To achieve complete resolution of the lesions, either multiple operations or a combination of surgery and sclerotherapy must be used and should be tailored to the characteristics of each patient. .
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Bleomycin/therapeutic use , Head and Neck Neoplasms/therapy , Lymphangioma, Cystic/therapy , Picibanil/therapeutic use , Punctures/methods , Sclerosing Solutions/therapeutic use , Brazil , Cross-Sectional Studies , Combined Modality Therapy/methods , Follow-Up Studies , Injections, Intralesional , Remission Induction , Retrospective Studies , Sclerosing Solutions/administration & dosage , Treatment OutcomeABSTRACT
Las malformaciones linfáticas peviamente denominadas linfangiomas son anomalías en el desarrollo normal del sistema linfático, con interrupción de su flujo y formación de cavidades quísticas con linfa. El 95 por ciento se localiza en cuello y axila, siendo extremadamente rara la localización pancreática en niños. Las malformaciones linfáticas pancreáticas deben diferenciarsede otras masas quísticas del páncreas. Las localizadas en la cabeza del páncreas requieren, para su exéresis, una duodenopancreatectomía.Comunicamos el caso de un paciente de13 meses de edad con una malformación linfática quística en la cabeza del páncreas, a quien se le realizó una duodenopancreatectomía.Un drenaje incesante de linfa del lecho tumoral llevó al deterioro inmunitario y a una sepsis incontrolable. Se plantean alternativas terapéuticas no quirúrgicas y se realiza una revisión de la bibliografía.
Subject(s)
Humans , Male , Infant , Lymphangioma, Cystic/therapy , Pancreaticoduodenectomy , Pancreas/pathologyABSTRACT
Se presenta un caso de linfangioma gigante de cuello en un neonato nacido por parto céfalovaginal. La dificultad para alimentarlo, por el tamaño de la masa, llevó a intervenir el linfangioma cavernoso a los seis días de vida con evolución postquirúrgica favorable. Se revisan los criterios actuales sobre el diagnóstico prenatal, el manejo del parto, las nuevas terapias disponibles y el procedimiento ex útero intraparto (EXIT) con soporte placentario, que ofrece nuevas perspectivas para los recién nacidos con obstrucción severa de la vía aérea superior.
Subject(s)
Lymphangioma, Cystic , Lymphangioma, Cystic/surgery , Lymphangioma, Cystic/congenital , Lymphangioma, Cystic/therapyABSTRACT
Estudiamos paciente multípara con diagnóstico ecográfico de hidropesia fetal, estudio genético mediante amniocentesis síndrome de Turner, ecografía obstétrica reporta higroma quístico de 20 semanas; como causa de la hidropesia fetal está el higroma quístico, con alteraciones cardíacas, y cromosómicas, incompatibles con la vida.
Subject(s)
Cordocentesis , Edema , Electrophoresis , Lymphangioma, Cystic/diagnosis , Lymphangioma, Cystic/therapy , PolyhydramniosABSTRACT
O linfangioma cistico é uma doença rara, mais freqüentemente encontrada em crianças e, ocasionalmente, em adultos. É considerada uma neoplasia benigna de origem linfática. Habitualmente se localiza na regiäo cervical e axilas e raramente é encontrrado na cavidade abdominal, especialmente no retroperitônio. É apresentado um caso raro de lifangioma cístico retroperitoneal gigante benigno, de localizaçäo pélvica numa paciente adulta. O trratamento foi a ressecçäo do tumor por via laparotômica com excelente resultado terapêutico. Säo discutidos os achados clínicos, laboratoriais, cirúrgicos, anatomopatológicos e evoluçäo pós-operatória.(au)