Follow-up of complex unresectable lymphangiomas.

Our purpose was to determine the natural history of unresectable lymphangiomas. From 1986-1992, 11 cases of unresectable lymphangiomas were seen in our institution (age 1 month to 14 years). Locations affected included cervical (8), mediastinal (6), and abdominal (3). Presenting symptoms included abdominal pain, respiratory problems, chylothorax, pleural effusions, and pneumococcal sepsis. Attempts at total excision were performed in all but one patient who had biopsy only. The tumor that could not be removed was then observed for the development of complications. Follow-up of these 11 patients ranged from 2 to 6 years. Two have completely regressed, five have stabilized, and four have required repeat operation. Of the five that have stabilized, none have developed complications such as infection or compression secondary to the mass. In an asymptomatic patient, it appears that the portion of the lymphangiomas remaining will regress or at least not progress, and no further resections were required.