INTRALESIONAL BLEOMYCIN SCLEROTHERAPY: AN EFFECTIVE TREATMENT OF CYSTIC HYGROMA IN CHILDREN

Intralesional Bleomycin Sclerotherapy

Abstract

Objective: To study the outcome of intralesional sclerotherapy with injection Bleomycin in cystic hygroma in children.
Study Design: A case series.
Place and Duration of Study: The department of Pediatric Surgery at Military Hospital, Rawalpindi, Pakistan from Jan 2011 to Dec 2012.
Patients and Methods: All patients with peripheral cystic hygroma (CH) presenting to us, were enrolled in the study. The cyst was aspirated in the operation theater under sedation. Injection bleomycin 0.5 mg /kg diluted in 10-15 cc of distilled water was injected in the cyst at multiple sites. Injection was repeated after every month depending upon the response.
Results: A total of 30 patients reported to the department with superficial cystic hygroma, 12 were males (40%) and 18 were females (60%), age ranged from 15 days to 8 years. Cervico-facial was the most common site. Results were assessed in terms of excellent (complete resolution), good (> 50% reduction in size) and poor (< 50% reduction in size). In 2 patients, complete resolution was achieved after maximum seven shots of intra-lesional bleomycin injections (IBI), while 18/30 (60%) resolved after single dose. Twenty seven patients (90%) resolved completely, 2 (6.6%) had good response, 1 (3.3%) showed poor response. Minor complications were noted which were treated by symptomatic treatment. No major side effects or recurrence were noted in maximum 2 years follow up.
Conclusion: Intralesional bleomycin sclerotherapy is safe and effective as primary treatment in cystic hygroma.