OK-432 Sclerotherapy in Submucosal Microcystic Pharyngeal Lymphangioma: An Effective Therapeutic Approach

Introduction: Lymphatic malformations, traditionally called lymphangiomas, are localized congenital malformations of the lymphatic system that occur most commonly in the head and neck region. There are many modalities of treatment, including surgical excision and sclerotherapy.

Objectives: To report the successful treatment of a male patient presenting submucosal lymphangioma with OK-432 sclerotherapy.

Resumed Report: A 2-month-old male patient presented with inspiratory stridor and respiratory dysfunction. At physical examination, a cervical mass was detected. He underwent an airway endoscopy, which showed infiltration of the naso- and oropharyngeal mucosa, and a computed tomography scan which showed a cervical macrocystic lymphangioma and submucosal microcystic pharyngeal lymphangioma. He persisted with worsening of the respiratory distress and a tracheostomy was performed. Surgery was not warranted because of the extension of the lesion. He underwent OK-432 sclerotherapy in a regimen of 2 mL per session, two cycles of four sessions each. Serial airway endoscopies showed improvement of the lesion at the end of two cycles of treatment, which lead to decannulation at the age of 3 years.

Conclusion: The use of OK-432 seems to be an attractive approach for submucosal microcystic lymphangioma patients not warranted surgery, as much as for macrocystic forms, with excellent response in this case, without important adverse effects. Patient could be decannulated within a few cycles of treatment.