Publication:

Outcome and clinical efficacy of bleomycin and doxycycline percutaneous sclerotherapy for treatment of paediatric lymphatic malformations in a limited resource setting

Background The aim was to study the role of bleomycin and doxycycline as a cheap and readily available sclero-therapeutic agent in the treatment of lymphatic malformations in paediatric populations of poor resource setting.

Methods It was a longitudinal study. A total of 23 paediatric cases with distinct types of lymphatic malformations were treated with injection sclerotherapy. Bleomycin and doxycycline used for microcystic and macrocystic lesion type respectively. The patient was followed up to complete remission. The level of evidence was Level II and type of evidence was prognosis study.

Results Commonest site of lesion was neck (78.3%), followed by cheeck (8.7%), chest, shoulder and suprapubic region. Only 21.7% of patients had good reduction (50-89%) in their lesion volume on first follow up. Overall 43.4% of patients showed a reasonable reduction in lesion volume during the follow-up period. Almost 3/4th of patients improved symptomatically on the first follow up visit. Macrocystic lesion showed an excellent response to treatment (50-89% volume reduction) in 33.3% of cases while only 16.7% of microcystic ad 12.5% of the mixed lesion showed a similar response to treatment.

Conclusions Doxycycline sclerotherapy can be a primary treatment modality in macrocystic and mixed macrocystic lesions. It is inexpensive and widely available and has minimal side effects. In contrast, bleomycine as a sclero-therapeutic agent showed an inadequate response in size reduction of microcystic lesions.