Evaluation of management of lymphangiomas in a tertiary care hospital: a prospective, open label, clinical study

Abstract

Background: Lymphangiomas are rare benign congenital tumours, involving both the head and the neck and causing obstructing symptoms in the upper airways as well as aesthetic anomalies. They consist in localized centers of abnormal development of the lymphatic system. Present in 2 forms- infiltrative form (firm in consistency) and cystic form (soft and compressible) in neck, known as cystic hygroma. Surgical resection still remains the best treatment for lymphangiomas; other treatment options, such as sclerotherapy have been proposed as an alternative to reduce the impact and complications of surgery.

Methods:A prospective, open label clinical study of 36 months duration was conducted on 44 consecutively admitted cases of lymphangioma in age group of 0-21 years of both genders. A through detailed history and clinical examination was undertaken. Local Symptoms, skin changes and vascular affect if any was recorded.Unresected lymphangiomas can be treated by radiation, sclerotherapy and steroids.

Results:Maximum cases were in the age group of 0-14 years, M: F ratio 1.9:1. Majority of patients were drawn from lower class of the society (56%). Majority of patients (84%) were non-smokers, non-tobacco chewers and non-alcoholics. Site of lymphangioma was head and neck 72% followed by shoulder 18%. 86% of lymphangiomas were non-infected and maximum number of cases 88% stayed in hospital for about 1 week. In 87% cases healing was complete in about 2 weeks. Total surgical excision is the most successful treatment modality of all other options available for its treatment.

Conclusions:A correct diagnosis, multidisciplinary approach, optimal treatment and assessment can provide optimal treatment of lymphangiomas.