Sclerotherapy for cervical cystic lymphatic malformations in children. Our experience with computed tomography-guided 98 % sterile ethanol insertion and a review of the literature

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• 作者：Pietro Impellizzeri ; Carmelo Romeo ; Francesca Astra Borruto ; Francesca Granata ; Gianfranco Scalfari ; Francesco Saverio De Ponte ; Marcello Longo
• 关键词：Cystic lymphatic malformation ; Children's ethanol sclerotherapy
• 刊名：Journal of Pediatric Surgery
• 出版年：2010
• 出版时间：December 2010
• 年：2010
• 卷：45
• 期：12
• 页码：2473-2478
• 全文大小：375 K

文摘

Purpose

The treatment of cystic lymphatic malformations of the neck and mediastinum is controversial. Surgical management may be limited by the invasiveness of the procedure, the complex anatomy of this region, and the high recurrence rate. An alternative therapeutic method is sclerotherapy. We report our experience in the treatment of cystic lymphatic malformations of the neck by computed tomography (CT)-guided instillation of 98 % sterile ethanol in children.

Methods

Eight children with clinical suspicion of cervical cystic lymphatic malformation were assessed by ultrasonography (US) and magnetic resonance imaging (MRI) to define the location, size, and number of cystic cavities. The CT-guided instillation of 98 % sterile ethanol was performed. Cystic fluid was analyzed by fine-needle aspiration cytology. Clinical and US or MRI follow-up was performed after 1 and 3 months and at 1 and 2 years.

Results

The results were excellent with complete disappearance of the lesion in 7 (87.5 % ) of 8 patients. One patient (12.5 % ) with satisfactory results required a second alcohol injection with an excellent outcome. No allergic reactions or complications were observed.

Conclusions

The CT-guided 98 % sterile ethanol sclerotherapy is a good alternative to surgical therapy. This procedure seems accurate, minimally invasive, safe, low cost, and reliable without untoward complications. Moreover, it does not exclude later surgical treatment.