Surgical excision was once considered the mainstay of treatment for lymphangiomas. However, that paradigm is now changing with sclerotherapy emerging as a viable alternative. A 22-year-old girl presented with a mucopurulent and painful discharge from an extensive wound in the trunk. Chest roentogram showed a large soft tissue abnormality with multiple calcifications in the right upper abdomen and lower thorax. Magnetic resonance imaging revealed an extensive lobulated mass measuring 27 x 19 cm. Due to the extensive involvement of tissues, surgical excision did not appear to be a favourable option in this case. Local injections of bleomycin were successfully administered; resulting in complete regression of the lesion. There has been no recurrence at 2 years of follow up. Use of bleomycin sclerotherapy appears to be a safe and effective management strategy and obviates the need for primary surgery especially in extensive lymphangiomas.
Journal of the Pakistan Medical Association
(2010). Giant unresectable lymphangioma of the trunk managed via intra-tumour injections of bleomycin. Journal of the Pakistan Medical Association, 60(7), 605-7.
Available at: http://ecommons.aku.edu/pakistan_fhs_mc_surg_cardiothoracic/17