Non invasive management of haemangioma using intralesional bleomycin injection [IBI]

ABSTRACT

Vascular anomalies like haemangiomas are among the most common forms of congenital and neonatal dysmorphogenesis. Various treatment regimens have been documented including laser therapy, sclerotherapy, embolization, surgical resection or sometimes combination of these. Percutaneous sclerotherapy was developed as a minimally invasive treatment modality for these lesions. The aim of this study is to evaluate the effect of intra-lesional bleomycin injection [IBI] in management of haemangiomas as a sclerosing therapy. 45 patients [29 female and 16 male] aged [6 months - 3 years] presented with haemangioma were studied between August 2007 and February 2012. Patients were subjected to IBI and its effect was evaluated. Patients under six months of age or with recurrent haemangioma were excluded from the study. Complete resolution [excellent] in 27 patients [60%], marked improvement [good] in 10 patients [22.2%], mild improvement [fair] in 6 patients [13.3%] and poor in 2 patients [4.4%]. Complications were recorded in 13 [28.7%] of patients. Local complications were pain and swelling in 6 [13.3%], superficial ulceration in 4 [8.8%] and scaring in 1 [2.2%]. Systemic complication in the form of flu-like symptoms was recorded in 2 [4.4%] of patients. None of the patients presented with haematological toxic effects or signs of pulmonary involvement. During the follow up period [6 to 18 months] all treated cases did not have re-enlargement or recurrence of their lesions. IBI is an effective treatment in haemnangiomas. It obviates the need for invasive primary surgery or other systemic treatment regimens