Management of cystic lymphangioma in children: experience in Jos, Nigeria.

The management of cystic lymphangiomas (CL), especially in the head and neck region, presents challenges to the pediatric surgeon. This is a retrospective study of all children seen with lymphangioma at the Pediatric Surgical Unit of the Jos University Teaching Hospital from 1996 to 2004. There were 27 children, 14 (51.9%) were males and 13 (48.1%) were females (M:F = 1.2:1), with ages ranging from 2 days to 5 years (median 5 months). Majority (84.6%) of the patients were below 1 year. The head and neck region was the most frequent site of involvement. There were three cases of lymphangioma circumscriptum. Six (54.5%) of the 11 children with cervical CL presented with complications including infection in 4, respiratory obstruction in 3, ulcerated lesion in 1 and intracystic hemorrhage with rapid increase in cyst size in 1. Twenty-three children had either surgical excision or marsupialization. The main complications were wound infections and respiratory obstructions, which led to five deaths. Six children had recurrences, some of which occurred at sites which were normal at the initial or previous excision. The mortality rate was high (34.8%), mainly due to respiratory obstruction and asphyxia in the head and neck lesions. Head and neck region was the most commonly involved site by CL. The management of CL at this site is associated with significant morbidity and a high rate of mortality.