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2.
Tech Vasc Interv Radiol ; 22(4): 100632, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31864531

RESUMO

Complex lymphatic anomalies include a variety of disorders with overlapping clinical, histological and imaging features. The often-confusing nomenclature used for lymphatic anomalies limits timely diagnosis and treatment. The updated 2018 classification of the International Society for the Study of Vascular Anomalies divides lymphatic anomalies into several subsets.1 Newer imaging techniques including intranodal and magnetic resonance lymphangiography have improved our understanding of anatomy and function of the lymphatic system. Advances in medical, interventional, and surgical treatments have opened a realm of new therapeutic options for patients with complex lymphatic disorders.


Assuntos
Anormalidades Linfáticas/terapia , Humanos , Anormalidades Linfáticas/diagnóstico por imagem , Anormalidades Linfáticas/fisiopatologia , Linfografia , Imagem por Ressonância Magnética , Osteólise Essencial/diagnóstico por imagem , Osteólise Essencial/fisiopatologia , Osteólise Essencial/terapia , Valor Preditivo dos Testes , Resultado do Tratamento
3.
Tech Vasc Interv Radiol ; 22(4): 100631, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31864533

RESUMO

The approach to treating common (cystic) lymphatic malformations (LMs) has evolved significantly over the last decade due to clinical research and recent developments in molecular biology. Surgery, sclerosing agents, and medical drugs with specific targets for biological therapy have been reported for the management of LMs. We will discuss the importance to standardize the location and imaging characterization of LMs to improve the knowledge about the outcome of the different therapeutic options. Our goal is to help the reader understand the different options for the management of LMs with the balance between risk and benefit for the patients.


Assuntos
Cistos/terapia , Anormalidades Linfáticas/cirurgia , Soluções Esclerosantes/administração & dosagem , Escleroterapia , Cistos/diagnóstico por imagem , Cistos/fisiopatologia , Humanos , Anormalidades Linfáticas/diagnóstico por imagem , Anormalidades Linfáticas/fisiopatologia , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Resultado do Tratamento
4.
Tech Vasc Interv Radiol ; 22(4): 100635, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31864534

RESUMO

Vascular malformations are generally congenital benign lesions that have multiple variations in treatment algorithms. Surgery can be used as a single modality or as an adjunct in multimodal therapy to treat these lesions. Here we discuss surgical treatment of the major vascular malformations, including lymphatic, venous, and arteriovenous malformations. We explain some of the basic principles to resection of simple and complex lesions and adjunctive therapies. These adjunct therapies include chemotherapeutic injections, embolization, and laser therapy. Surgical resection of complex lesions should only be performed by an experienced vascular anomalies surgeon. A team approach is generally necessary to provide safe and effective treatment. While surgery for these complex lesions is an option, the most important principle to adhere to when treating any of these lesions is that the treatment should be no worse than the disease.


Assuntos
Anormalidades Linfáticas/cirurgia , Malformações Vasculares/cirurgia , Procedimentos Cirúrgicos Vasculares , Tomada de Decisão Clínica , Humanos , Anormalidades Linfáticas/diagnóstico por imagem , Anormalidades Linfáticas/fisiopatologia , Seleção de Pacientes , Fatores de Risco , Resultado do Tratamento , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/fisiopatologia , Procedimentos Cirúrgicos Vasculares/efeitos adversos
7.
Pediatrics ; 144(3)2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31462447

RESUMO

Lymphatic malformation (LM) is a congenital disorder resulting from an abnormal development of lymphatic vessels. LM may result in problems of cosmesis and functional impairment, including airway compression. An 11-year-old girl was referred to our department with increasing dysphagia caused by a large left cervical LM with a long history of treatment. Because of the LM location, surgical resection was not an option, and various therapies, including use of picibanil, had proven ineffective. Celecoxib treatment (100 mg/day) was initiated for local pain management. Softening of the lesion was observed 2 weeks after treatment initiation, and the dose was increased to 200 mg/day with additional shrinking of the LM over the next 2 weeks. With parental consent, celecoxib was continued, with a 65% reduction in volume achieved at 6 months. The patient discontinued treatment at 12 months, and the LM volume increased. Control over the LM was achieved with resumption of celecoxib treatment. After 2 years of treatment, the LM persists, but the size of the malformation is significantly smaller. No adverse effects of celecoxib treatment were observed. The anti-cyclooxygenase-2 effect of celecoxib prevented lymphatic vessel growth through an inhibition of cyclooxygenase-2 activity in the conversion of prostaglandin to prostaglandin E2. In conclusion, celecoxib may be a promising therapeutic agent for LM management.


Assuntos
Celecoxib/uso terapêutico , Inibidores de Ciclo-Oxigenase 2/uso terapêutico , Anormalidades Linfáticas/tratamento farmacológico , Obstrução das Vias Respiratórias/etiologia , Criança , Transtornos de Deglutição/etiologia , Feminino , Humanos , Anormalidades Linfáticas/complicações , Anormalidades Linfáticas/diagnóstico por imagem , Imagem por Ressonância Magnética , Adesão à Medicação , Recidiva
8.
Acta Otolaryngol ; 139(8): 713-719, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31169474

RESUMO

Background: Lymphatic malformations (LMs) are caused due to abnormal lymphatic development, and mainly occur in neonates or young children. At present, the role of surgery in the treatment of head and neck LMs is still controversial, focusing mainly on surgical efficacy and indications. Objective: This study aimed to explore the effect and influential factors of surgical treatment in children with head and neck LMs, hoping to provide a basis for rational selection of surgical indications. Methods: This retrospective study enrolled 128 children with head and neck LMs and underwent surgical treatment in Beijing Children's Hospital from May 2007 to June 2016. They were classified into three morphological groups: macrocystic, microcystic, and mixed. Based on de Serres staging, they were divided into five groups: stage I to V. The local lesion control rate, complication rate, and recurrence rate were summarized and analyzed. Results: The rate of completely controlled and almost completely controlled in cases with head and neck LMs was 71.1%. The postoperative complication rate was 13.3%, and the postoperative recurrence rate was 11.9%. Statistically significant difference was found for local lesion control and postoperative recurrence rates between different morphological and clinical staging groups. Furthermore, the complication rate showed a significant difference between different morphological groups, but not between clinical staging groups. Conclusions: Surgical resection in children with macrocystic, low-stage, or neck-limited LMs demonstrated better therapeutic effect, with fewer complications. However, the effect remained poor and had more complications for microcystic, diffused and high-stage patients. High stage and incomplete resection are considered as the main factors for postoperative recurrence. Current staging system for LMs has important predictive value in the prognosis of head and neck LMs. For LMs in posterior pharyngeal space, plasma ablation has certain advantages.


Assuntos
Cistos/cirurgia , Anormalidades Linfáticas/cirurgia , Criança , Pré-Escolar , Feminino , Seguimentos , Cabeça/cirurgia , Humanos , Recém-Nascido , Anormalidades Linfáticas/diagnóstico por imagem , Masculino , Pescoço/cirurgia , Complicações Pós-Operatórias , Estudos Retrospectivos , Ultrassonografia
9.
Semin Ultrasound CT MR ; 40(2): 147-156, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31030738

RESUMO

Pediatric patients present emergently with a wide variety of infectious, inflammatory, congenital, traumatic, and neoplastic conditions. Imaging plays a crucial role in distinguishing among the potential diagnoses, as often, history and physical exam is limited in these young sick patients. Understanding the imaging appearance of the range of conditions which are commonly encountered and their potential complications, facilitates appropriate and expedient management. The radiologist must recognize the benefits of the various imaging modalities available and help the clinician choose among the possibilities depending on the clinical status of the patient.


Assuntos
Diagnóstico por Imagem/métodos , Otopatias/diagnóstico por imagem , Oftalmopatias/diagnóstico por imagem , Corpos Estranhos/diagnóstico por imagem , Anormalidades Linfáticas/diagnóstico por imagem , Doenças Respiratórias/diagnóstico por imagem , Emergências , Cabeça/diagnóstico por imagem , Humanos , Pescoço/diagnóstico por imagem
10.
Radiology ; 291(3): 774-780, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30938628

RESUMO

Background The Fontan operation is performed for surgical palliation of single ventricle physiology. This operation is usually preceded by a superior cavopulmonary connection (SCPC); lymphatic abnormalities after SCPC may be demonstrated at MRI and prior to the Fontan operation. Purpose To determine if the degree of neck and thoracic lymphatic abnormalities at T2-weighted MRI in patients after superior cavopulmonary connection (SCPC) correlated with surgical outcomes from the Fontan procedure. Materials and Methods Patients for whom SCPC was performed for palliation of single ventricle disease who underwent chest MRI between July 2012 and May 2015 at a single institution were retrospectively reviewed. T2-weighted images were scored as lymphatic type 1 (little or no T2 mediastinal and supraclavicular signal) to type 4 (T2 signal into both the mediastinum and the lung parenchyma). Fontan takedown, duration of post-Fontan hospitalization and pleural effusion, postoperative plastic bronchitis, need for transplant, and mortality were tabulated. The relationship between lymphatic type and clinical outcomes was evaluated by using analysis of variance (ANOVA), the Kruskal-Wallis H test, and the Fisher exact test. Results A total of 83 patients (mean age, 7.9 years ± 2.6) were evaluated. Among these 83 patients, 53 (64%) were classified with type 1 or 2 lymphatic abnormalities, 17 (20%) with type 3, and 12 (16%) with type 4. The rate of failure of Fontan completion was higher in patients with type 4 than in type 1 or 2 (54% vs 2%, respectively; P = .004). Need for cardiac transplant (one of 13 [8%]) and death (three of 13 [23%]) occurred only in type 4. Median postoperative length of stay was longer for patients with type 4 than for those with types 1 or 2 (29 days vs 9 days, respectively; P < .01). Conclusion Greater MRI-based severity of lymphatic abnormalities in patients prior to planned Fontan procedure was associated with failure of Fontan completion and longer postoperative stay. © RSNA, 2019 Online supplemental material is available for this article.


Assuntos
Técnica de Fontan , Anormalidades Linfáticas/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Criança , Pré-Escolar , Técnica de Fontan/efeitos adversos , Técnica de Fontan/mortalidade , Técnica de Fontan/estatística & dados numéricos , Cardiopatias Congênitas/mortalidade , Cardiopatias Congênitas/cirurgia , Humanos , Tempo de Internação , Anormalidades Linfáticas/etiologia , Sistema Linfático/diagnóstico por imagem , Sistema Linfático/patologia , Imagem por Ressonância Magnética , Pescoço/diagnóstico por imagem , Pescoço/patologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Tórax/diagnóstico por imagem , Tórax/patologia , Resultado do Tratamento
11.
BMJ Case Rep ; 12(4)2019 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-31015245

RESUMO

General lymphatic anomaly (GLA) is a very rare disorder, characterised by multifocal lymphatic malformations into various tissues that is due to congenital abnormalities of lymphatic development. No treatment has ever proved its efficiency.We report a 22-year-old man with recurrent bronchial casts due to thoracic involvement of GLA. After a 6-month treatment with sildenafil (20 mg three times a day), a phosphodiesterase 5 inhibitor, chest CT scan showed a complete regression of ground-glass opacities and lung function test results improved substantially and remained stable for 1 year. The treatment was well tolerated.This observation suggests that sildenafil may be a therapeutic approach to be tested in thoracic involvement of GLA.


Assuntos
Pneumopatias/congênito , Pneumopatias/tratamento farmacológico , Linfangiectasia/congênito , Linfangioleiomiomatose/tratamento farmacológico , Citrato de Sildenafila/uso terapêutico , Humanos , Pneumopatias/diagnóstico por imagem , Pneumopatias/patologia , Linfangiectasia/diagnóstico por imagem , Linfangiectasia/tratamento farmacológico , Linfangiectasia/patologia , Linfangioleiomiomatose/congênito , Linfangioleiomiomatose/diagnóstico por imagem , Anormalidades Linfáticas/diagnóstico por imagem , Masculino , Inibidores da Fosfodiesterase 5/uso terapêutico , Doenças Raras , Testes de Função Respiratória/métodos , Citrato de Sildenafila/administração & dosagem , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Adulto Jovem
12.
Int J Pediatr Otorhinolaryngol ; 121: 164-172, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30917301

RESUMO

INTRODUCTION: Congenital head and neck pathology may cause direct postnatal airway obstruction. Prenatal diagnosis facilitates safe delivery with pre- and perinatal airway assessment and management and Ex-Utero-Intrapartum-Treatment (EXIT) if necessary. Fetoscopic airway evaluation can optimize the selection of patients in need of an EXIT procedure. METHODS: Description of 11 consecutive fetuses, born with a potential airway obstruction between 1999 and 2011 and treated at the University Hospitals Leuven, with a long-term follow-up until 2018. An algorithm including fetoscopic airway evaluation is presented. RESULTS: In utero imaging revealed seven teratomas, one fourth branchial pouch cyst, one thymopharyngeal duct remnant, one lymphatic malformation and one laryngeal atresia. A multidisciplinary team could avoid EXIT in eight patients by ultrasonographic (n = 2) or fetoscopic (n = 6) documentation of accessible airways. Three patients needed an EXIT-to-airway-procedure. Neonatal surgery included tracheostomy during EXIT (n = 2) and resection of teratoma (n = 7) or branchiogenic pathology (n = 3). All patients do well at long-term (minimum 54 months) follow-up. CONCLUSIONS: Combining prenatal imaging and perinatal fetoscopy, EXIT-procedure and neonatal surgery yields an optimal long-term outcome in these complex patients. Fetoscopy can dramatically reduce the number of EXIT-procedures.


Assuntos
Obstrução das Vias Respiratórias/diagnóstico por imagem , Obstrução das Vias Respiratórias/cirurgia , Anormalidades Congênitas/diagnóstico por imagem , Fetoscopia , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Teratoma/diagnóstico por imagem , Obstrução das Vias Respiratórias/congênito , Obstrução das Vias Respiratórias/etiologia , Algoritmos , Anormalidades Congênitas/cirurgia , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/congênito , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Recém-Nascido , Laringe/anormalidades , Anormalidades Linfáticas/complicações , Anormalidades Linfáticas/diagnóstico por imagem , Período Periparto , Gravidez , Teratoma/complicações , Teratoma/congênito , Teratoma/cirurgia , Fatores de Tempo , Traqueostomia , Ultrassonografia Pré-Natal
13.
Eur Ann Otorhinolaryngol Head Neck Dis ; 136(2): 109-112, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30819600

RESUMO

OBJECTIVES: The authors present the guidelines of the French Society of Otorhinolaryngology (SFORL) for the diagnosis of cervical lymphatic malformation in adults and children. METHODS: A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group, and finalized in a coordination meeting. Guidelines were graded A, B, C or expert opinion, by decreasing level of evidence. RESULTS: The SFORL recommends that complete ENT examination should be performed to identify lesions at high risk of complication or associated with poor prognosis. In case of diagnostic doubt, especially in latero-cervical or oral floor lesions, fine-needle aspiration cytology should be performed before therapeutic decision-making. One or more validated classifications should be used to assess treatment efficacy and monitor progression. The reliability of antenatal diagnosis should be ensured by associating MRI to ultrasound. In antenatal diagnosis, the locoregional extension of the cervical lymphatic malformation should be evaluated accurately for prognosis, and associated malformations should be screened for, to guide treatment options.


Assuntos
Anormalidades Linfáticas/diagnóstico , Otolaringologia/normas , Sociedades Médicas/normas , Adulto , Criança , Pré-Escolar , França , Humanos , Lactente , Anormalidades Linfáticas/classificação , Anormalidades Linfáticas/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Imagem Multimodal/métodos , Diagnóstico Pré-Natal , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia Pré-Natal/métodos
14.
Plast Reconstr Surg ; 143(3): 558e-564e, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30817659

RESUMO

BACKGROUND: Lymphatic malformation is a congenital lymphatic disorder. Although a few lymphangiographic and lymphoscintigraphic studies of lymphatic malformation exist, its lymphatic flow has not been fully assessed, and a classification system has not yet been established. However, indocyanine green lymphography has been developed to safely provide a fine assessment of lymph flow in the treatment of lymphedema. In addition, indocyanine green lymphography has been shown to be helpful in detecting the lymphatic malformation inflow for the treatment of refractory microcystic type lymphatic malformation using the venous anastomosis technique. Therefore, the authors aimed to reveal the in vivo lymph flow around the lymphatic malformation using indocyanine green lymphography, and to design a classification system according to the observed patterns. METHODS: Indocyanine green lymphography was performed in 20 sequential pediatric patients with lymphatic malformation (aged 11 months to 10 years). Most of the cases were intractable, with microcystic or mixed-type lymphatic malformation. RESULTS: All patients successfully completed lymphography with clear observations. The flow patterns were classified into four types: type 1 had a strong detectable inflow; type 2 had multiple small observable inflows; type 3 had a superficial lymph flow over the lesion; and type 4 had a flow around the lymphatic malformation, without any connections to the lesion. CONCLUSION: The proposed classification system may aid in the further development of surgical treatments for lymphatic malformation.


Assuntos
Corantes Fluorescentes/administração & dosagem , Anormalidades Linfáticas/diagnóstico por imagem , Vasos Linfáticos/diagnóstico por imagem , Linfografia/métodos , Imagem Óptica/métodos , Anastomose Cirúrgica/métodos , Criança , Pré-Escolar , Feminino , Humanos , Verde de Indocianina/administração & dosagem , Lactente , Anormalidades Linfáticas/cirurgia , Vasos Linfáticos/anormalidades , Vasos Linfáticos/cirurgia , Masculino , Veias/cirurgia
16.
Radiología (Madr., Ed. impr.) ; 61(1): 85-89, ene.-feb. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-185081

RESUMO

Presentamos un caso de linfangiohemangiomas múltiples (hemolinfangiomas, hemangiolinfangiomas o malformación vascular combinada linfática venosa) con afectación torácica y abdominal en un paciente asintomático. Describimos los hallazgos en imagen de esta patología, que son bastante característicos y pueden permitir un diagnóstico preciso. En nuestro conocimiento, no existen referencias en la literatura científica de un caso similar


We present a case of multiple lymphangiohemangiomas (hematolymphangiomas, hemangiolymphangiomas, or combined lymphatic venous malformation) with thoracic and abdominal involvement in an asymptomatic patient. We describe and illustrate the imaging findings in this disease, which are quite characteristic and can enable an accurate diagnosis. To our knowledge, there are no other reports of similar cases in the scientific literature


Assuntos
Humanos , Masculino , Adulto , Linfangioma/diagnóstico por imagem , Hemangioma/diagnóstico por imagem , Malformações Vasculares/diagnóstico por imagem , Neoplasias Abdominais/diagnóstico por imagem , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias Esplênicas/diagnóstico por imagem , Diagnóstico Diferencial , Anormalidades Linfáticas/diagnóstico por imagem
17.
Pediatr Radiol ; 49(5): 586-592, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30613845

RESUMO

BACKGROUND: Children with Noonan syndrome are known to have increased risk for lymphatic disorders, the extent and nature of which are poorly understood. OBJECTIVE: Our objective was to describe the imaging findings of the central lymphatic abnormalities in children with Noonan syndrome who underwent central lymphatic imaging. MATERIALS AND METHODS: We conducted a single-center retrospective review of all children with a confirmed history of Noonan syndrome who presented for lymphatic imaging over a 5-year period. Imaging evaluation was performed on unenhanced T2-weighted (T2-W) imaging, dynamic-contrast MR lymphangiography or conventional lymphangiography. Two readers evaluated the imaging in consensus for the distribution of fluid on T2-W imaging and for lymphatic flow of intranodal contrast agent and thoracic duct abnormalities on dynamic-contrast MR lymphangiography and conventional lymphangiography. We performed a chart review for clinical history and outcomes. RESULTS: We identified a total of 10 children, all but one of whom had congenital heart disease. Presenting symptoms included chylothorax (n=9) and ascites (n=1). Nine had T2-W imaging, seven had dynamic-contrast MR lymphangiography, and seven had conventional lymphangiography. All with T2-W imaging had pleural effusions. On both dynamic-contrast MR lymphangiography and conventional lymphangiography, perfusion to the lung was seen (n=6), with intercostal flow also seen on dynamic-contrast MR lymphangiography (n=6). The thoracic duct was not present in three children and the central thoracic duct was not present in three. A double thoracic duct was seen in two children. CONCLUSION: Children with Noonan syndrome and clinical evidence of lymphatic dysfunction have central lymphatic abnormalities characterized by retrograde intercostal flow, pulmonary lymphatic perfusion, and thoracic duct abnormalities.


Assuntos
Anormalidades Linfáticas/diagnóstico por imagem , Anormalidades Linfáticas/etiologia , Linfografia/métodos , Imagem por Ressonância Magnética/métodos , Síndrome de Noonan/complicações , Ascite/diagnóstico por imagem , Criança , Pré-Escolar , Quilotórax/diagnóstico por imagem , Meios de Contraste , Óleo Etiodado , Fluoroscopia , Humanos , Imagem Tridimensional , Lactente , Recém-Nascido , Compostos Organometálicos , Derrame Pleural/diagnóstico por imagem , Estudos Retrospectivos , Ducto Torácico/anormalidades , Ultrassonografia de Intervenção
19.
Int J Obstet Anesth ; 38: 142-145, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30243809

RESUMO

High-dose volatile anesthesia is the most common method of achieving uterine relaxation for Ex Utero Intrapartum Therapy (EXIT) procedures. Other methods employ nitroglycerin for additional uterine relaxation with or without remifentanil for additional fetal analgesia. We report a combination approach including one minimum alveolar concentration of volatile anesthetic plus nitroglycerin and remifentanil infusions, to provide timely uterine relaxation under general anesthesia for both mother and fetus, during two EXIT procedures.


Assuntos
Anestesia Geral/métodos , Anestesia Obstétrica/métodos , Anormalidades Craniofaciais/diagnóstico por imagem , Anormalidades Craniofaciais/terapia , Anormalidades Linfáticas/diagnóstico por imagem , Anormalidades Linfáticas/terapia , Útero/efeitos dos fármacos , Adulto , Analgésicos Opioides/administração & dosagem , Evolução Fatal , Feminino , Humanos , Recém-Nascido , Masculino , Nitroglicerina/administração & dosagem , Gravidez , Remifentanil/administração & dosagem , Ultrassonografia Pré-Natal/métodos , Vasodilatadores/administração & dosagem
20.
J Surg Res ; 233: 256-261, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30502256

RESUMO

BACKGROUND: Lymphatic malformations (LMs) are congenital and arise from errors in vascular embryogenesis. LMs are categorized by cyst size as microcystic, macrocystic, or combined. Abdominal LMs are rare. Surgical resection of abdominal LMs has been the mainstay of therapy, but recurrence and morbidity are high. We sought to determine the effectiveness of sclerotherapy treatment for abdominal LM. METHODS: A single-center, retrospective review from 2014 to 2018 was conducted evaluating pediatric patients with abdominal LM. RESULTS: Ten patients were included, n = 9 had macrocystic LM and one patient had combined disease. The average age at first treatment was 6.8 y. The most common presenting symptoms were abdominal distention, pain, infection, and anemia. Preprocedural imaging was performed for all patients; median pretreatment volume was 1572.9 cm3 (range, 67.2-13,226.4). LMs were accessed using ultrasound guidance and injected with opacified doxycycline. Patients received a mean of 7.1 sclerotherapy injections. Complications included intraperitoneal doxycycline extravasation (n = 1), managed conservatively, and LM infection (n = 1), treated with intravenous antibiotics and drainage. One patient went on to surgical resection due to inability gain stable intracystic access; follow-up ultrasonography showed no recurrence. Postprocedural imaging was available in n = 8. Volume decreased by 96.7% after sclerotherapy. The median remaining volume was 0 cm3 (range, 0-599.7) (P = 0.016). Postsclerotherapy magnetic resonance imaging was obtained in n = 6, with complete resolution in 83.3%. All patients had resolution of presenting symptoms. Follow-up duration was 12.3 mo. CONCLUSIONS: Initial results demonstrate that sclerotherapy is an effective and durable treatment for symptom resolution and volume reduction of abdominal LM.


Assuntos
Doxiciclina/administração & dosagem , Anormalidades Linfáticas/terapia , Escleroterapia/métodos , Prevenção Secundária/métodos , Cavidade Abdominal/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Extravasamento de Materiais Terapêuticos e Diagnósticos/epidemiologia , Extravasamento de Materiais Terapêuticos e Diagnósticos/etnologia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Anormalidades Linfáticas/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Recidiva , Estudos Retrospectivos , Escleroterapia/efeitos adversos , Resultado do Tratamento , Ultrassonografia de Intervenção
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