Treatment of Lymphangiomas in Children: An Update of Picibanil (OK‐432) Sclerotherapy

  • John H. Greinwald
    Division of Pediatric Otolaryngology Department of Otolaryngology‐Head and Neck Surgery University of Iowa Iowa City Iowa
  • Diane K. Burke
    Division of Pediatric Otolaryngology Department of Otolaryngology‐Head and Neck Surgery University of Iowa Iowa City Iowa
  • Yukato Sato
    Department of Radiology University of Iowa Iowa City Iowa
  • Rolland I. Poust
    College of Pharmacy University of Iowa Iowa City Iowa
  • Ken Kimura
    Department of Surgery University of Iowa Iowa City Iowa
  • Nancy M. Bauman
    Division of Pediatric Otolaryngology Department of Otolaryngology‐Head and Neck Surgery University of Iowa Iowa City Iowa
  • Richard J. H. Smith
    Division of Pediatric Otolaryngology Department of Otolaryngology‐Head and Neck Surgery University of Iowa Iowa City Iowa

抄録

<jats:p>Picibanil (OK‐432) is a sclerosing agent derived from a low‐virulence strain of <jats:italic>Streptococcus pyogenes</jats:italic> that induces regression of macrocystic lymphangiomas. This report describes a prospective, nonrandomized trial to evaluate the efficacy of Picibanil in the treatment of 13 affected children ranging in age from 1 to 94 months. On average, 4.1 fluoroscopically guided intracystic injections were performed per child, with an average total dose of 0.56 mg of Picibanil. As judged by physical examination and radiographic studies, 5 children (42%) showed a complete or substantial response, and 2 children (16%) showed an intermediate response. No response was seen in 5 children (42%), 2 of whom had massive craniofacial lymphangioma. Factors that contribute to failure with Picibanil sclerotherapy are the presence of a significant micro‐cystic component to the lesion, massive craniofacial involvement, and previous surgical resection. Macrocystic lymphangiomas of the infratemporal fossa or cervical area have the best response to therapy.</jats:p>

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