Subject(s)
Diabetes Insipidus/etiology , Hypophysectomy/adverse effects , Hypothalamus/metabolism , Inappropriate ADH Syndrome/etiology , Pituitary Gland, Posterior/metabolism , Pituitary Neoplasms/surgery , Vasopressins/metabolism , Child, Preschool , Deamino Arginine Vasopressin/therapeutic use , Dexamethasone/therapeutic use , Diabetes Insipidus/drug therapy , Diabetes Insipidus/physiopathology , Diuretics/therapeutic use , Drug Therapy, Combination , Humans , Hydrocortisone/therapeutic use , Hyponatremia/etiology , Hyponatremia/physiopathology , Hypopituitarism/etiology , Hypothalamus/injuries , Inappropriate ADH Syndrome/drug therapy , Inappropriate ADH Syndrome/physiopathology , Male , Nerve Degeneration , Pituitary Neoplasms/complications , Puberty, Precocious/etiology , Puberty, Precocious/surgery , Secretory RateABSTRACT
Lymphangioma of the tongue is a rare and benign tumour involving congenital and cystic abnormalities derived from lymphatic vessels. Treatment modalities include surgery and a large number of different intralesional injections of sclerosing agents. Presently, OK-432 (Picibanil(®)) is the preferred sclerosant and when administered intralesionally will result in inflammation, sclerosis, and cicatricial contraction of the lesion. We report a case of microcystic lymphangioma of the tongue in a 5-year-old boy treated with an intralesional injection of OK-432. In the immediate postoperative period, the patient suffered severe diffuse swelling, progressive upper airway obstruction with inspiratory stridor, and respiratory distress requiring emergency fiberoptic nasotracheal intubation. Although OK-432 injections are found to be safe and effective as a first line of treatment for lymphangiomas, local swelling with potentially life-threatening airway compromise should be anticipated, especially when treating lesions near the upper airway.
