Thoracic duct lymphangioma and chylous ascites in a 24-year-old female

Lymphangiomas are rare and correspond to 0.7% to 4.0% of mediastinal tumors, and isolated mediastinal location occurs in 1% of cases. They are benign tumors that originate from a congenital malformation of the lymphatic vessels and are diagnosed more frequently in children less than 2 years of age. Chylous ascites is a clinical manifestation of thoracic duct lymphangioma and is composed of lymph accumulation caused by dilation of this lymphatic channel. It appears milky in the peritoneal cavity, containing triglyceride levels higher than 200 mg/dl. We report the case of a young patient with chylous ascites and lymphangioma of the thoracic duct, who was conservatively treated with octreotide and a low-fat diet with medium-chain triglycerides.

Tratamiento esclerosante del linfangioma facial. Presentación de un caso / Sclerotherapic treatment of facial lymphangioma

This article details the treatment of lymphangioma of the face with intralesional bleomycin: with a case report and literature review. Surgical treatment of lymphangioma of the face is a difficult task to achieve, due to close vicinity of the lesion to the facial nerve and possibility of scar tissue formation. Inefficient surgical removals generally will give rise to high recurrence rates because of infiltrative and diffuse extension of the lesion. However, complete cure has been described by non-surgical methods with intralesional bleomycin injection under ultrasonographic guidance. Lymphangioma is a rare congenital malformation of the lymphatic system, frequently seen in the head and neck. Percutaneous sclerotherapy of lymphangioma involves the injection of sclerosing substances into the lymphangioma. This study aims to evaluate the effectiveness of intralesional bleomycin sclerotherapy in the treatment of lymphangioma, and to determine the incidence of complications in the treatment. Intralesional bleomycin therapy was very effective in the treatment of lymphangioma. Bleomycin administered as intralesional injection was found to be safe as there was no lesions complicating or side effects observed in the study.

Malformación linfática facial mixta: Caso clínico / Mixed facial lymphatic malformation: Case report

Lymphangiomas are a common form of vascular malformation of the lymphatic vessels, mainly in the head and neck region. Most cases are progressive evolution and require a multidisciplinary approach. Currently, the first therapeutic option is sclerotherapy, leaving surgery for the treatment of remaining lesions. Objective: To present a case of facial lymphatic malformation (LM) treated with sclerotherapy, surgery and orthodontics in a 15-year follow up. Case report: A one-year-old female patient who consulted health professionals due to a progressive volume increase of the soft parts of her right cheek. The imaging study confirmed the diagnosis of microcystic lymphatic malformation. It was managed with OK-432 sclerotherapy and Bleomycin. At 2 years of age, the patient response was considered adequate; an intralesional submandibular surgical excision was then performed, with partial resection of the lesion. The biopsy confirmed the diagnosis of microcystic LM. Six months after, a re-resection was planned using the same approach and removing the remaining lesion, with favorable development until the age of 9 years when the patient required surgery and orthodontic management due to intraoral recurrence. No major developments until the age of 13 when a new orthodontic surgery and handling are planned to perform right oral commissure suspension. Conclusion: LM management by sclerotherapy, surgery, and orthodontics has shown the advantages of a multidisciplinary long-term treatment in this case.

El linfangioma corresponde a una malformación vascular de los vasos linfáticos, preferentemente de la región de cabeza y cuello. La mayoría de los casos son de evolución progresiva y requieren un manejo multidisciplinario. Actualmente la primera opción terapéutica es la esclerosis, reservando la cirugía para el tratamiento de las lesiones remanentes. Objetivo: Presentar un caso de malformación linfática (ML) facial, tratado con escleroterapia, cirugía y ortodoncia en un seguimiento a 15 años. Caso clínico: Paciente de sexo femenino que consulta al año de edad por aumento de volumen progresivo de partes blandas en su mejilla derecha. El estudio de imágenes confirmó el diagnóstico de Malformación Linfática microquística. Se manejó con esclerosis seriada con OK-432 y Bleomicina. A los 2 años de edad se consideró que la respuesta era adecuada, y se procedió a realizar extirpación quirúrgica intralesional submandibular, con resección parcial de la lesión. La biopsia confirmó el diagnóstico de ML microquística. Seis meses después se planificó nueva resección utilizando el mismo abordaje y extirpando lesión remanente, con evolución favorable hasta la edad de 9 años en que requiere cirugía y manejo por ortodoncia, por recidiva de lesión a nivel intraoral. Evolución favorable hasta que a la edad de 13 años se planifica nueva cirugía y manejo por ortodoncia para suspender la comisura bucal derecha. Conclusión: El manejo de la ML mediante escleroterapia, cirugía, y ortodoncia muestra en este caso las ventajas de un tratamiento multidisciplinarion a largo plazo.

Retroperitoneal and genital lymphangioma therapeutic challenges in a developing country

Lymphangiomas occur most commonly in the head and neck region, while other sites are rarely affected. A combination of retroperitoneal and genital lymphangioma is very rare indeed. Though congenital, it may persist into adulthood due to missed diagnosis and inadequate or total lack of treatment. A report of a 22-year-old male student who presented with recurrent multiloculated genital, thigh, groin and retroperitneal lymphangioma. He underwent surgical excision and adjuvant sclerotherapy using ethylene-diamine tetra acetic acid. There was an initial recurrence after surgery which responded satisfactorily to sclerotherapy. Complete surgical excision of lymphangioma may be precluded by vital structures but sclerotherapy produces satisfactory resolution. The difficulties in management with limited facilities for diagnosis and treatment are highlighted

Tratamiento del linfagioma en niños con fraciones ribosómicas bacterianas / Treatment of lymphangioma in children with bacterial ribosomal fractions

Introducción: el propósito del presente estudio fue demostrar la efectividad del extracto de las fracciones ribosómicas bacterianas como tratamiento del linfangioma en niños. Material y métodos: se realizó un análisis prospectivo de enero de 2003 a enero de 2006 de los pacientes que consultaron con diagnóstico de linfangioma en quienes se administró intracavitariamente extracto de fracciones ribosómicas bacterianas como único régimen terapéutico. Se aplicaron de 1 a 3 infiltraciones seriados con un intervalo de 1 mes entre cada uno...

Linfangioma cervical cavernoso en un gemelo: analísis crítico del diagnóstico y manejo perinatal / Cervical lymphangioma in a twin: prenatal diagnosis and perinatal management

Los tumores fetales son hallazgos infrecuentes y muchas veces no diagnosticados prenatalmente. El objetivo de este trabajo es presentar y discutir en forma critica el diagnostico y manejo prenatal de un gemelo portador en un linfangioma cervical cavernoso, incluyendo el procedimiento EXIT.

Fetal cervical tumors are uncommon, and not always prenataly diagnosticated. We describe the prenatal findings and prenatal management in a case of cervical cavernous lymphangioma in one twin, including EXIT procedure.

Intralesional bleomycin injection- A primary therapy for peripheral lymphangiomas

To evaluate the efficacy of intralesional Bleomycin Injection [IBI] as a primary therapy for peripheral lymphangiomas in children. A prospective study was conducted at NICH Karachi from January 2003 to December 2005. Patients with peripheral lymphangiomas were included in the study. Exclusion criteria included previously treated lymphangiomas, infected lesions, intra-thoracic and intra-abdominal lesions. Thirty three patients were included in the study. All were treated with Intralesional Bleomycin Injection [IBI]. After aspiration of fluid from the lesion, 0.5 mg/kg of Bleomycin diluted in saline was administered at different sites into the lesion. Depending upon the size of lesion and age of patient, procedure was performed in operating theatre under local or general anesthesia. Reduction in size was seen in 90% cases [n=29], out of them 30% [n=10] showed near complete disappearance and 63% [n=21] showed good response. Two patients [6%] showed poor response and they underwent surgery. Few patients had minor complications like fever, pain, redness and increase in the size after injection. All these complications were managed conservatively with symptomatic treatment and no patient required hospitalization. IBI is an effective therapy for lymphangiomas, with results comparable to surgical excision. It has the added advantage of avoiding inadvertent injury to vital structures, scarring and other complications of surgery. We recommend it as a primary therapy for all peripheral lymphangiomas

Linfangioma circunscrito superficial: Presentación de un caso / Superficial circumscript lymphangioma: Presentation of a case

Paciente masculino, quien presenta un linfangioma ciscunscrito superficial con buen resultado a la crioterapia

Linfangioma circunscrito: tratamiento con laser de CO2 / Linphangioma circunscriptum: treatment with CO2 laser

Se presenta un caso de linfangioma circunscrito congénito con recurrencia postquirúrgica, manejado con vaporización laser de CO2

Linfangiomas quísticos abdominales en el niño

Presentamos seis pacientes afectados de linfangioma quístico del abdomen (LQA), ocurridos entre enero de 1987 y enero de 1994, en el Hospital de Niños "Baca Ortiz" de Quito. El LQA es una rara enfermedad típica de la infancia, que no es realmente un tumor, sino una displasia linfática consecutiva a un trastorno de conexión entre los espacios primitivos linfáticos, provenientes de las hendiduras mesenquimatosas y del sistema central de los troncos colectores. Destacamos el LQA como una entidad quirúrgica, de diagnóstico basado en la ecografía y a tomarse en cuenta en el diagnóstico diferencial de los tumores abdominales.

Criocirugía en lesiones de boca / Cryosurgery in mouth lesions

La criocirugía es un procedimiento de tratamiento hipotérmico de lesiones benignas propiamente dichas, lesiones benignas con posibilidades de transformación neoplásicas y de lesiones malignas de boca. Se comunican 158 casos analizándose las técnicas utilizadas y los resultados en las distintas patologías. Este método sólo o asociado a la cirugía o radiofrecuencia permitió la extirpación de lesiones bucales benignas o malignas sin pérdida de sustancia o sea con la conservación anatómica y funcional de la zona tratada. Tiene como ventaja que no daña al hueso ni a las piezas dentarias aunque la lesión esté adherida a estos elementos anatómicos.

Revisión bibliográfica de linfangioma / bibliographical Overhaul of linfangioma

Los linfangiomas llamados Higromas quísticos son neoformaciones que comúnmente se presentan en la cabeza y región cervical. Aparecen tempranamente, hacia los 3 años de edad, son de origen embrionario; puede ser una masa blanda única o multiquística, constituida por vasos linfáticos, generalmente del color de la piedl o de tonalidad azulada. Histologícamente se clasifican en: cavernosos, quísticos y simples o patológicamente en: capilar, esponjoso quístico, circunscrito y mixto. Por lo general el único signo es la deformidad en el sitio donde se encuentra la lesión, puede haber más sintomatología si compromete a los órganos vecinos; así los linfangiomas intraabdominales ocasionan oclusiones intestinales, distensión abdominal; los del cuello dificultad respiratoria cianosis...