Hazim M, Moses S S, Tan I P
University Malaysia Sarawak (UNIMAS), Department of ORL-HNS, Jalan Datuk Mohd Musa, 94300 Kota Samarahan, Sarawak Malaysia.
Med J Malaysia. 2016 Dec;71(6):328-330.
Lymphangiomas are congenital malformations of the lymphatic system with characteristic dilated endothelium-lined spaces. It is vulnerability to infection or chemical irritants cause spontaneous reduction in size and in some cases complete resolution. Intralesional injection of OK-432 or Picibanil (lyophilized incubation mixture of Group A Streptococcus pyogenes of human origin) is slowly gaining recognition as its safety and efficacy standards have shown to avoid complications resulting from surgical interventions. The objective of this study was to evaluate the clinical outcomes of cystic hygroma patients who received OK-432 injections.
In between 2011 and 2013, six patients with cystic hygroma received intralesional injection of OK-432. All the patients were assessed clinically and radiologically either via ultrasound, computer tomography (CT) or magnetic resonant imaging (MRI) prior to and after receiving the injections. Patients' response towards treatment was classified as total shrinkage, marked shrinkage (greater than 50% reduction in size), slight shrinkage (less than 50% reduction in size) or non-responsive to treatment.
Mean duration of follow-up was 12 months. Total shrinkage was achieved in one patient, marked shrinkage in three patients and one patient experienced mild shrinkage. Only one out of the six patients showed no response to treatment. None of the patients in this study experienced serious complications or adverse effects post intralesional injection of OK-432.
Intralesional OK-432 injection is an effective and safe alternative in treating cystic hygroma.
淋巴管瘤是淋巴系统的先天性畸形，具有特征性的内皮细胞衬里的扩张间隙。它易受感染或化学刺激物影响，可导致大小自发缩小，在某些情况下可完全消退。瘤内注射OK-432或匹多莫德（人源化脓性链球菌A组冻干培养混合物）作为一种治疗方法正逐渐得到认可，因为其安全性和有效性标准已表明可避免手术干预引起的并发症。本研究的目的是评估接受OK-432注射的囊状水瘤患者的临床疗效。
2011年至2013年期间，6例囊状水瘤患者接受了OK-432瘤内注射。所有患者在注射前后均通过超声、计算机断层扫描（CT）或磁共振成像（MRI）进行临床和影像学评估。患者对治疗的反应分为完全缩小、明显缩小（大小缩小超过50%）、轻微缩小（大小缩小小于50%）或对治疗无反应。
平均随访时间为12个月。1例患者实现完全缩小，3例患者明显缩小，1例患者轻度缩小。6例患者中只有1例对治疗无反应。本研究中没有患者在瘤内注射OK-432后出现严重并发症或不良反应。
瘤内注射OK-432是治疗囊状水瘤的一种有效且安全的替代方法。
