Olive Aliza, Moldenhauer Julie S, Laje Pablo, Johnson Mark P, Coleman Beverly G, Victoria Teresa, Flake Alan W, Adzick N Scott
Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
J Pediatr Surg. 2015 Oct;50(10):1711-5. doi: 10.1016/j.jpedsurg.2015.03.066. Epub 2015 Apr 29.
BACKGROUND/PURPOSE: The purpose of this study is to describe the prenatal findings and postnatal outcomes of fetuses with axillary lymphatic malformations.
Retrospective chart review of fetuses with the prenatal diagnosis of isolated axillary lymphatic malformation detected between 2009 and 2013.
There were 8 fetuses diagnosed with isolated axillary lymphatic malformation. Median gestational age at diagnosis was 20.5 (19-28) weeks. All fetuses were evaluated by serial ultrasound and ultrafast fetal MRI. Two pregnancies were electively terminated. All continued pregnancies reached term, and all fetuses were delivered by cesarean section. None of the fetuses developed polyhydramnios or hydrops fetalis. Only one patient had an associated malformation (coarctation of the aorta). All patients were evaluated postnatally by MRI. Treatment included sclerotherapy only (1), sclerotherapy followed by surgical resection (1), surgical resection only (3), and observation (1). The median postnatal hospital stay was 8 (6-15) days. Three cases recurred after the initial treatment, two after surgery and one after sclerotherapy. On a median follow up of 2.1 years, all patients have some degree of visible residual disease. There were no deaths.
Prenatal diagnosis of axillary lymphatic malformation is increasing with improved technology. Axillary lymphatic malformations are usually isolated developmental anomalies that do not affect fetal health. Postnatal management options include surgery, sclerotherapy, and observation. Recurrences and residual disease after all types of treatment are frequent. This should be communicated to the parents at the time of prenatal counseling.
背景/目的：本研究旨在描述患有腋窝淋巴管畸形胎儿的产前检查结果及产后结局。
对2009年至2013年间产前诊断为孤立性腋窝淋巴管畸形的胎儿进行回顾性病历审查。
有8例胎儿被诊断为孤立性腋窝淋巴管畸形。诊断时的中位孕周为20.5（19 - 28）周。所有胎儿均通过系列超声和超快胎儿磁共振成像进行评估。2例妊娠被选择性终止。所有继续妊娠的胎儿均足月分娩，且所有胎儿均通过剖宫产娩出。无胎儿发生羊水过多或胎儿水肿。仅1例患者伴有相关畸形（主动脉缩窄）。所有患者产后均接受磁共振成像评估。治疗方法包括仅硬化治疗（1例）、硬化治疗后手术切除（1例）、仅手术切除（3例）和观察（1例）。产后住院时间的中位数为8（6 - 15）天。3例在初始治疗后复发，2例在手术后复发，1例在硬化治疗后复发。中位随访2.1年时，所有患者均有一定程度的可见残留病灶。无死亡病例。
随着技术的进步，腋窝淋巴管畸形的产前诊断率在提高。腋窝淋巴管畸形通常为孤立性发育异常，不影响胎儿健康。产后管理选项包括手术、硬化治疗和观察。所有类型治疗后复发和残留病灶都很常见。在产前咨询时应将此情况告知父母。
