Authors: Annamaria WeitzTuoretmaa Riitta Rautio Jan Valkila Harri KeskiSäntti Leo KeskiNisula Jussi Laranne
Publish Date: 2013/05/07
Volume: 271, Issue: 2, Pages: 385-390
Abstract
Lymphatic malformations LMs are rare congenital tumors of the lymphatic system often affecting the head and neck area Because of cosmetic and functional symptoms most patients need to be treated Traditionally surgical treatment has been considered to be the firstline treatment for LM However it is challenging because of the need for complete excision The risk of poor cosmetic result and damage to surrounding structures is high Since Ogita presented OK432 as a treatment for LM in 1987 it has been widely used as the primary treatment Many papers have been published on this topic but with relatively short followup times We present a material of 36 LMs treated with OK432 during the period of 1999–2009 and with an average followup time of 6 years Immediate posttreatment results were compared with the late followup findings Primary and late response to therapy was evaluated with an MRI scan by measuring the change in lesion size At the followup visit all patients were clinically examined and they answered a symptom questionnaire Later 26/36 patients were also available for a quality of life questionnaire Primarily 67 demonstrated a complete or marked response At the followup 64 showed a complete or marked response in 11 the final response was better than the initially observed and only 2 patients had relapsed The initial response predicted the longterm outcome accurately and the effect of OK432 sclerotherapy seems to be long lasting According to the MRI evaluation 80 and subjectively 94 of the patients benefitted from the treatment Quality of life questionnaire showed high posttreatment satisfaction We found OK432 sclerotherapy to be a safe and effective treatment with a long lasting effect in the management of macrocystic LMs
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