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Lymphatic malformation treated by percutaneous sclerotherapy

A Case Treated by Dr. Monica Pearl

Lymphatic malformations are a type of low-flow congenital vascular malformation. First line of therapy for this type of lesion is percutaneous sclerotherapy. This baby was treated with a single sclerotherapy session with doxycycline at three months of age. Clinical and ultrasonographic follow-up at one year showed no recurrence.

This is a black and white, sagittal T2 and T1-post gadolinium weighted images show a T2 hyperintense, unilocular, peripherally enhancing left neck mass consistent with a macrocystic lymphatic malformation.

Sagittal T2 and T1-post gadolinium weighted images show a T2 hyperintense, unilocular, peripherally enhancing left neck mass consistent with a macrocystic lymphatic malformation.

The right side shows a baby with a large mass in her or his neck. The left side shows an x-ray image of the mass within the baby's neck. The lymphatic malformation is treated by percutaneous sclerotherapy, in which a small needle is placed into the lesion and a sclerosing agent is injected.

The lymphatic malformation is treated by percutaneous sclerotherapy, in which a small needle is placed into the lesion and a sclerosing agent is injected.

You can watch the video of the contrast injection here.

Clinical photograph 2 weeks after the procedure shows no visible mass. No residual lymphatic malformation was present at one year. The floppy skin overlying the left neck continues to involute.

Clinical photograph 2 weeks after the procedure shows no visible mass. No residual lymphatic malformation was present at one year. The floppy skin overlying the left neck continues to involute.

Publication:

Puttgen K, Pearl M, Tekes A, Mitchell S. Update on pediatric extracranial vascular anomalies of the head and neck. Childs Nerv Syst. 2010 Oct; 26 (10): 1417-33. Epub 2010 Aug 10.

 

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