Complications of lymphangiomas in children

https://doi.org/10.1016/0022-3468(92)90316-YGet rights and content

Abstract

One hundred ninety-three cases of lymphangioma presenting in children were reviewed over a 10-year period. The diagnosis was established before 5 years of age in 87.0%. The distribution of lymphangiomas was: cervical (31.4%), craniofacial (18.9%), extremity (18.9%), trunk (9.2%), intraabdominal (9.2%), cervicoaxillothoracic (4.9%), multiple (3.8%), cervicomediastinal (2.2%), and intrathoracic (1.6%). Of 164 patients undergoing primary therapy, total excision was performed in 77.4% and partial excision in 20.7% with recurrence rates of 11.8% and 52.9%, respectively. Thirty-eight percent of all operations for lymphangiomas were performed for resection of recurrent or residual disease. The incidence of postoperative complications was 31.3%. Forty-four additional procedures were required to manage these complications. Sclerotherapy with 50% dextrose was used as an adjunct in 9.5%. Recurrences were seen after total resection in 17.6% of operations in which 50% dextrose was used and 11.8% in which it was not used. Seroma formation was noted in 3.5% of total resections and 40.0% of resections for recurrent disease in which adjunctive sclerotherapy with 50% dextrose was used. Seromas occurred in 9.8% of wounds in which local drains were used and 3.6% of wounds in which drains were not used. Infectious complications occurred after 6.6% of operations using perioperative antibiotics and 3.5% not using antibiotics. The management of lymphangiomas in children remains a difficult problem. Despite being benign lesions, lymphangiomas are attended by a high rate of morbidity from complications of the disease and its management. Complete excision still offers the best chance for complete cure. Sclerotherapy with 50% dextrose is not beneficial in the management of recurrent disease or postoperative seromas. Local drains and perioperative antibiotics do not appear to diminish the incidence of seromas and infectious complications, respectively.

References (38)

  • NC Bhattacharyya et al.

    Lymphangiomas in children

    Aust N Z J Surg

    (1981)
  • GA Harkins et al.

    Lymphangioma in infancy and childhood

    Surgery

    (1960)
  • JE Brooks

    Cystic hygroma of the neck

    Laryngoscope

    (1973)
  • TL Kennedy

    Cystic hygroma-lymphangioma: A rare and still unclear entity

    Laryngoscope

    (1989)
  • SR Cohen et al.

    Lymphangiomas of the larynx in infants and children: A survey of pediatric lymphangioma

    Ann Otol Rhinol Laryngol

    (1986)
  • PH Ward et al.

    Surgical approach to cystic hygroma of the neck

    Arch Otolaryngol

    (1970)
  • D Chait et al.

    Management of cystic hygromas

    Surg Gynecol Obstet

    (1974)
  • M Galofre et al.

    Results of surgical treatment of cystic hygroma

    Surg Gynecol Obstet

    (1962)
  • M Saijo et al.

    Lymphangioma: A long-term follow-up study

    Plast Reconstr Surg

    (1975)
  • Cited by (241)

    • Cervicofacial cystic lymphangiomas in 17 childrens: A case series

      2022, Annals of Medicine and Surgery
      Citation Excerpt :

      In comparison with the literature, FLANAGAN reported a success rate of surgical treatment of 75%, with a follow-up of more than 5 years in 74% of patients [12]. HANCOCK reported a remission rate of 77.4% for all locations combined (52.5% of tumors were located in the head and neck) [22]. The same was true for ALQAHTANI which obtained a complete improvement in 77% of patients (34.9% of tumors of the head and neck) [23].

    • Lymphangioma of the tongue in a pediatric patient

      2021, Journal of Pediatric Surgery Case Reports
      Citation Excerpt :

      Unfortunately, infection sometimes occurs, occasionally resulting in Ludwig's angina [10]. Moreover, seroma formation, recurrent cellulitis, minor bleeding, and lymph fluid leakage are reported postoperative complications [11]. The treatment of lymphangioma relays on several factors, including size, type, involvement and infiltration to other tissues.

    • Cervical cystic lymphangioma in a child

      2021, Journal of Pediatric Surgery Case Reports
    • Congenital lymphangiomatosis: Multidisciplinary approach

      2020, Journal of Pediatric Surgery Case Reports
    View all citing articles on Scopus

    Presented at the 22nd Annual Meeting of the American Pediatric Surgical Association, Lake Buena Vista, Florida, May 15–18, 1991.

    View full text