Gösta Claesson1, Richard Kuylenstierna. 1. Department of Pediatric Surgery, Astrid Lindgren's Hospital, Karolinska Hospital, Stockholm 171 76, Sweden. gosta.claesson@ks.se
Abstract
BACKGROUND/ PURPOSE: Operating lymphatic malformation (LM) may lead to nerve damage with permanent cosmetic disturbance. Even sclerosants as ethanol and Sotradecol may sometimes harm more than cure. The purpose with this study was to evaluate the effect of a relatively new drug for intralesional injections, OK-432. METHODS: The diagnosis of LM was made clinically by means of ultrasound and MRT and/or CT. Thirty-two patients (28 children) with LM were consecutively enrolled in the study. Twenty-nine (27 children) had not been treated previously: 17 (15 children) had macrocysts (MAC), four microcysts (MIC) and eight had combined cysts (CC). Three patients (one child) had got previous treatment without any curative effect. All patients got intralesional injections with OK-432 at intervals according to a previously published protocol (Läkartidningen, 95 (1998) 2074). RESULTS: No serious adverse effects were seen. The results obtained were excellent in all with macrocysts but in one, who was pretreated with ethanol, where no LM-regression was seen. None of four with MIC-LM required further therapy; for two of them the results were excellent. Of 10 with CC, seven showed excellent results. Only one required surgery. CONCLUSION: OK-432 is effective and is proposed to be the first choice of treatment for LM.
BACKGROUND/ PURPOSE: Operating lymphatic malformation (LM) may lead to nerve damage with permanent cosmetic disturbance. Even sclerosants as ethanol and Sotradecol may sometimes harm more than cure. The purpose with this study was to evaluate the effect of a relatively new drug for intralesional injections, OK-432. METHODS: The diagnosis of LM was made clinically by means of ultrasound and MRT and/or CT. Thirty-two patients (28 children) with LM were consecutively enrolled in the study. Twenty-nine (27 children) had not been treated previously: 17 (15 children) had macrocysts (MAC), four microcysts (MIC) and eight had combined cysts (CC). Three patients (one child) had got previous treatment without any curative effect. All patients got intralesional injections with OK-432 at intervals according to a previously published protocol (Läkartidningen, 95 (1998) 2074). RESULTS: No serious adverse effects were seen. The results obtained were excellent in all with macrocysts but in one, who was pretreated with ethanol, where no LM-regression was seen. None of four with MIC-LM required further therapy; for two of them the results were excellent. Of 10 with CC, seven showed excellent results. Only one required surgery. CONCLUSION: OK-432 is effective and is proposed to be the first choice of treatment for LM.
Authors: C Luzzatto; R Lo Piccolo; F Fascetti Leon; G F Zanon; T Toffolutti; A Tregnaghi Journal: Pediatr Surg Int Date: 2005-10-25 Impact factor: 1.827