Surgical excision: an effective initial therapeutic option in the management of giant macrocystic lymphatic malformations in children

Hassan, Moaied A.; Gatea, Hasan K.; Ja’afar, Thura K.

doi:10.1186/s43159-019-0013-9

Surgical excision: an effective initial therapeutic option in the management of giant macrocystic lymphatic malformations in children

Authors

Abstract

Background
Lymphatic malformations are rare benign cystic tumors that result from localized disordered embryologic development of the lymphatic system and can develop anywhere in the body, predominantly in the head and neck. These lesions are classified according to the diameter of the largest cystic cavity within the lesion into microcystic and macrocystic types. Historically, surgical excision has been considered the mainstay of treatment and still remains the first therapeutic option of choice for many surgeons particularly for giant macrocystic lesions. Several alternative therapeutic modalities emerged including intralesional sclerotherapy and laser therapy with encouraging results.
Results
Asymptomatic mass with parental cosmetic and functional concerns was the mode of presentation in six (66.7%) patients. Seven (77.8%) patients were presented before the age of 2 years. Six (66.7%) of the patients had their lesions in the neck. Complete surgical excision was achieved in eight (88.9%) patients without any evident significant injury to vital neurovascular structures. None of the patients had any difficulties with breathing, swallowing, or phonation and cosmetic results were satisfactory in the majority (88.9%) of them.
Conclusion
Radical surgical excision of giant macrocystic lymphatic malformations in children is possible in experienced hands. It is an effective and safe initial therapeutic option and gives satisfactory esthetic and functional results.

Keywords