Lymphangioma Circumscriptum Post Radiotherapy for Penile Cancer Treated with CO2 Laser.

Lymphangioma circumscriptum (LC) is a rare, benign condition, predominantly characterized by the malformation of lymphatic skin vessels. Its onset may be congenital or due to secondary causes such as radiotherapy, infections, or surgical procedures. We present the case of a 55-year-old patient with a pathologic history of squamous cell carcinoma of the penis followed by radical penectomy. Due to metastasis to the locoregional lymph nodes, the entire affected area was subsequently treated with radiation therapy, receiving a total dose of 55.8 Gray. Eight years after this treatment, translucent vesicles filled with a clear liquid appeared on the scrotum. Histopathology confirmed the diagnosis of LC and therapy with CO2 laser was applied, resulting in a favorable outcome. LC of the scrotum may present a long-term radiotherapy-induced complication of this site. Our clinical experience showed that the CO2 laser was the therapy of choice as the vesicles entirely disappeared and healed as white scar-like lesions.

Evaluation of a New Method for the Treatment of Invasive, Diffuse, and Unexcisable Lymphangiomas of the Oral Cavity with Defocus CO2 Laser Beam: A 20-Year Follow-Up.

OBJECTIVE: The aim of our study is to evaluate the efficiency of a new therapeutic method using CO2 laser to avoid mutilation or total excision for the treatment of invasive, large and unexcisable oral lymphangiomas. BACKGROUND DATA: Cystic lymphatic malformations, or lymphangiomas, are mature lymphatic malformations, consisting of abnormal lymphatic vessels. Surgical excision is considered by most surgeons to be the treatment of choice for lymphangioma. Laser beam has been used to treat superficial or small lymphatic malformations by excision or by photocoagulation, and to excise or photocoagulate small lymphangiomas. PATIENTS AND METHODS: Seventeen patients with diffuse and unexcisable lymphangiomas were treated using a CO2 laser with specific settings: beam was 2 W in noncontact and defocus mode, power density was 0.63 W/cm2 for irradiation time in the range of 3-5 min, and the estimated energy density range was 114.65-191.02 J/cm2. The beam diameter at the tissular impact point was ±2 cm. The laser beam was defocused to provoke a deep heat generation that would dry up the lymphatic tissues and induce deep tissue necrosis that heals by fibrous tissue process. RESULTS: The results were satisfactory and stable, with localized recurrence in three cases. The recurrent areas were re-treated using the same technique successfully and with no further recurrence. CONCLUSIONS: The use of CO2 laser under the suggested irradiation conditions can be considered a useful technique for the treatment of invasive lymphangiomas.

Mediastinal Hodgkin lymphoma arising from cystic lymphangioma: case report in a child.

Mediastinal disease is a frequent clinical presentation in children with Hodgkin lymphoma. It is usually due to mediastinal lymphadenopathy or involvement of the thymus gland. Cystic lymphangiomas are benign tumors of the lymphatic system, and less than 1% present as a solitary mediastinal mass. To our knowledge, there has been no report in the literature describing Hodgkin lymphoma arising from cystic lymphangioma. In this report, we describe a patient with mediastinal cystic lymphangioma, from which Hodgkin lymphoma was determined to have arisen.

Infected giant lymphangioma circumscriptum treated with a combination therapy.

Lymphangioma circumscriptum is an uncommon benign disorder of skin and subcutaneous tissues characterized by dilated lymphatic channels. It is an uncommon vascular tumor and it rarely becomes infected. We report a 20-year-old man who had an infected giant tumor in his left thigh. After an extensive resection and radiofrequency energy therapy, he recovered well with an acceptable cosmetic result. We followed up the patient for 2 years without any recurrence.

Radiotherapy in congenital vulvar lymphangioma circumscriptum.

Congenital lymphangioma circumscriptum (LC) of the vulva is a rare disorder with unknown etiology. Treatment options include ablative approaches such as laser therapy, sclerotherapy, and surgery. Radiotherapy has been shown to be effective in the management of congenital lymphangioma especially in the thoracic and abdominal lesions. In this report, we describe a patient with persistent vulvar LC despite sclerosing therapy and several surgical excisions. She was treated with a course of external radiotherapy and showed a dramatic objective response with relief of all symptoms.

Laser therapy of vascular lesions.

Since the first construction of a laser by Maiman in 1960 and the first clinical application of a laser in the therapy of skin lesions by Leon Goldman, laser therapy has become an important therapeutic modality in dermatology. Various lasers can be used for the treatment of different vascular and non-vascular lesions. According to our results, vascular lesions constitute the most important indication for laser therapy in dermatology.

Diffuse thoracic lymphangiomatosis with disseminated intravascular coagulation in a child.

An 8.5-year-old girl who presented with chronic cough and hemoptysis underwent a CT scan of the chest showing diffuse mediastinal and parenchymal infiltration and pleural effusion, and laboratory findings showed disseminated intravascular coagulation. Disseminated lymphangiomatosis was diagnosed after an open-lung biopsy. She was treated by systemic steroids, interferon, tamoxifen, chemotherapy, and radiation but died of respiratory failure and disseminated intravascular coagulation 2 years after the diagnosis. This patient represents a rare presentation of diffuse pulmonary lymphangiomatosis together with disseminated intravascular coagulation, involving both the mediastinum and pulmonary parenchyma, in a child.

Treatment of hemorrhagic lymphatic malformation of the tongue with a pulsed-dye laser.

Hemorrhagic lymphatic malformation (formerly called hemolymphangioma) of the tongue is an uncommon malformation that may pose both functional and cosmetic problems for the patient. The challenge has been to find a conservative treatment with low morbidity and better results than those achieved with surgical excision, which has been the mainstay of therapy. We report a case of successful treatment of a hemorrhagic lymphatic malformation of the tongue with a variable-pulse 595-nm pulsed-dye laser (Vbeam; Candela Corp, Wayland, Mass). In this patient, pulsed-dye laser treatment of the hemorrhagic lymphatic malformation achieved satisfactory functional and cosmetic outcomes. Its use in superficial vascular lesions of the mucosa should be considered.

Two cases of orbital lymphangioma associated with vascular abnormalities of the retina and iris.

PURPOSE: To report 2 patients with combined intraocular and orbital vascular abnormalities. DESIGN: Two interventional case reports. MAIN OUTCOME MEASURES: Clinical and pathologic findings. INTERVENTION/TESTING: Orbitotomy, fluorescein angiography, magnetic resonance imaging, and radiation therapy. RESULTS: Two patients presented with vision loss, intermittent proptosis, and cosmetic deformity. These patients had orbital lymphangioma, ipsilateral retinal and iris vascular malformations, and smaller corneal diameter on the affected side. CONCLUSIONS: The coexistence of these diverse vascular anomalies supports the established hypothesis of pluripotential orbital vascular anlagen. Disruptive influences of various types during embryogenesis or development may produce a variety of congenital orbital and intraocular vascular malformations.

Lymphangiolipoma of the lower extremity: 5-year radiological follow-up after radiotherapy treatment.

This report describes a lymphangiolipoma located in the extremity in a young woman. Radiotherapy effectively controlled recurrent lymphangiolipoma of the left upper leg that had been judged inoperable by limb-sparing surgical resection. In the case presented here, a dose of 50 Gy in 25 fractions over 5 weeks was employed without long-term complications after 5-year follow-up.

Successful control of extensive thoracic lymphangiomatosis by irradiation.

Lymphangiomas are very rare benign tumours, believed to arise from congenital malformations of the lymphatic system. They grow very slowly, but are capable of massive expansion and infiltration of the surrounding tissues. If left untreated they can cause serious and sometimes fatal complications. The thorax is commonly affected, with involvement of the ribs, pleura, pericardium, lung parenchyma, mediastinum and vertebrae. Treatment depends on the extent of the disease. While local excision is the treatment of choice for localized lesions, radiotherapy is used for more extensive disease. In this report we describe three patients with extensive thoracic lymphangiomatosis who were treated successfully with irradiation alone. The value of early diagnosis and treatment is emphasized.

Radiotherapy is a useful treatment for lymphangioma circumscriptum: a report of two patients.

Lymphangioma circumscriptum is a rare non-malignant skin tumour, conventionally treated by surgical resection, but with variable results. We report two cases, which, although unsuitable for excision, were treated successfully by radiotherapy and consider the place of this modality in managing this disorder. We conclude that radiotherapy is an effective treatment for unresectable lesions, or for patients who are unwilling to consider surgery.

Case report: mesenteric mixed haemangioma and lymphangioma; report of a case with 10 year follow-up after radiation treatment.

A patient with massive mixed haemangioma and lymphangioma of the mesentery first presented in childhood with ascites which subsided spontaneously and, subsequently, at 21 years of age, presented with gastrointestinal bleeding. At laparotomy, the lesion was found to involve 90% of the mesentery and was unresectable due to its bulk. Hence he was treated by radiotherapy (15 Gy/15 fractions/3 weeks followed by a boost of 5 Gy/4 fractions/4 days). He responded to the treatment. 10 years later he again experienced mild gastrointestinal bleeding which subsided spontaneously. This case illustrates the efficacy of radiotherapy in massive mesenteric haemolymphangiomas. Review of the literature revealed that surgical excision, embolization, and radiotherapy have been used in the treatment of haemangiomas and lymphangiomas. In unresectable cases, radiotherapy has a definite role in the management. A variety of doses has been employed in the literature. No definite dose-response relationship was identified.

[Abdominal organ-transcending tumors with special reference to peritoneal carcinosis. CT versus the surgical site]. / Abdominelle organüberschreitende Tumoren unter besonderer Berücksichtigung der Peritonealkarzionose. CT versus Operationssitus.

In 41 patients with a histologically confirmed peritoneal carcinomatosis (n = 29) or lymphangiomatosis (n = 12) the preoperative CT investigations of the abdomen were compared with intraoperative findings. CT findings were differentiated between direct or indirect signs. The sensitivity of the various CT signs of peritoneal carcinomatosis or lymphangiomatosis was between 66 and 100%. Abdominal CT studies proved to be a reliable preoperative method if the findings were examined closely. A precise review even of indirect signs is of high diagnostic value.

Fractionated beta-irradiation of a conjunctival lymphangioma.

Fractionated beta-radiation was applied on a conjunctival lymphangioma, which had been known for several years. Histological diagnosis was established 3 years previously. Excision was not possible because the tumor had involved a considerable part of the conjunctiva. Using a strontium-90 applicator a total dose of 30 Gy was applied in 6 fractions with 5 Gy each. The initial tolerance was satisfactory. No radiogenic damage occurred, an involution of the tumor could be observed. During a follow-up time of nearly 2 years no further progression was noted. We consider the beta-radiation as an interesting therapeutic alternative for conjunctival lymphangiomas which are difficult to treat surgically due to their size.

[Breast cancer following breast prosthesis and irradiation in childhood]. / Survenue d'un cancer du sein après prothèse mammaire et irradiation dans l'enfance.

The authors report a case of breast cancer developing 7 years after insertion of a breast prosthesis. This patient was 45 years old at the time of this discovery and had received low dose radiation during childhood for a haemolymphangioma of the homolateral axillary region. The possible factors predisposing development of cancer are discussed: haemolymphangioma, low dose axillary irradiation during childhood, peri-prosthetic fibrous capsule. These various points are examined in the light of data from the literature. The conclusions recall the necessity for clinical and radiological follow-up of breast prostheses, preferably performed by a plastic surgeon.