Amodeo Ilaria, Cavallaro Giacomo, Raffaeli Genny, Colombo Lorenzo, Fumagalli Monica, Cavalli Riccardo, Leva Ernesto, Mosca Fabio
Neonatal Intensive Care Unit Pediatric Dermatology Department Department of Pediatric Surgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
Medicine (Baltimore). 2017 Feb;96(8):e5984. doi: 10.1097/MD.0000000000005984.
Lymphatic malformations are benign anomalies derived from the abnormal development of lymphatic channels. Usually asymptomatic, they can cause compression on adjacent structures or present acute complications (bleeding or infection). Small asymptomatic lesions can be conservatively managed since the possibility of spontaneous regressions is described, while symptomatic lesions require active management. Less invasive therapeutic options are now preferred instead of surgery (sclerotherapy, laser therapy). However, there are not uniform therapeutic protocols.
We present the case of a term newborn with an abdominal cystic lymphangioma extending from the umbilical to the right inguinal area, reaching the medial surface of the right tight. Despite its large dimensions, which classically request surgical management, the patient was by chance asymptomatic, and the mass did not determine compression on the surrounding organs. Therefore, conservative management was tried, and a close clinical and radiological follow-up was started. This approach permitted a spontaneous regression of the mass and to avoid major surgical intervention.
Our purpose is to underline the possibility of conservative management of the major multicystic masses and to focus on less invasive therapeutic options, like sclerotherapy, oral therapy, and laser therapy.
淋巴管畸形是淋巴管异常发育产生的良性病变。通常无症状,但可压迫相邻结构或出现急性并发症(出血或感染)。由于存在自发消退的可能,小的无症状病变可采取保守治疗,而有症状的病变则需要积极治疗。现在更倾向于采用侵入性较小的治疗方法而非手术(硬化治疗、激光治疗)。然而,目前尚无统一的治疗方案。
我们报告一例足月新生儿病例,其腹部囊性淋巴管瘤从脐部延伸至右腹股沟区,直至右侧大腿内侧表面。尽管其体积较大,按照传统需要手术治疗,但该患儿偶然无症状,且肿块未对周围器官造成压迫。因此,尝试进行保守治疗,并开始密切的临床和影像学随访。这种方法使肿块自发消退,避免了重大手术干预。
我们的目的是强调对较大的多囊性肿块进行保守治疗的可能性,并关注侵入性较小的治疗方法,如硬化治疗、口服治疗和激光治疗。