Morovic I Carmen Gloria, Vidal T Claudia, Leiva V Noemí, Véliz M Sebastián
Rev Chil Pediatr. 2014 Dec;85(6):714-9. doi: 10.4067/S0370-41062014000600009.
Lymphangiomas are a common form of vascular malformation of the lymphatic vessels, mainly in the head and neck region. Most cases are progressive evolution and require a multidisciplinary approach. Currently, the first therapeutic option is sclerotherapy, leaving surgery for the treatment of remaining lesions.
To present a case of facial lymphatic malformation (LM) treated with sclerotherapy, surgery and orthodontics in a 15-year follow up.
A one-year-old female patient who consulted health professionals due to a progressive volume increase of the soft parts of her right cheek. The imaging study confirmed the diagnosis of microcystic lymphatic malformation. It was managed with OK-432 sclerotherapy and Bleomycin. At 2 years of age, the patient response was considered adequate; an intralesional submandibular surgical excision was then performed, with partial resection of the lesion. The biopsy confirmed the diagnosis of microcystic LM. Six months after, a re-resection was planned using the same approach and removing the remaining lesion, with favorable development until the age of 9 years when the patient required surgery and orthodontic management due to intraoral recurrence. No major developments until the age of 13 when a new orthodontic surgery and handling are planned to perform right oral commissure suspension.
LM management by sclerotherapy, surgery, and orthodontics has shown the advantages of a multidisciplinary long-term treatment in this case.
淋巴管瘤是淋巴管血管畸形的常见形式,主要发生在头颈部区域。大多数病例呈进行性发展,需要多学科方法治疗。目前,首选治疗方法是硬化治疗,手术则用于治疗残留病变。
介绍一例面部淋巴管畸形(LM)患者,在15年的随访中接受了硬化治疗、手术和正畸治疗。
一名1岁女性患者因右脸颊软组织体积逐渐增大而咨询医疗专业人员。影像学检查确诊为微囊性淋巴管畸形。采用OK-432硬化治疗和博来霉素进行治疗。2岁时,患者反应被认为良好;随后进行了病灶内下颌下手术切除,部分切除病变。活检确诊为微囊性LM。6个月后,计划采用相同方法再次切除,切除剩余病变,直至9岁时病情发展良好,此时患者因口腔内复发需要手术和正畸治疗。直到13岁时都没有重大进展,此时计划进行新的正畸手术并进行右侧口角悬吊处理。
在该病例中,通过硬化治疗、手术和正畸治疗对LM进行管理显示了多学科长期治疗的优势。