Large
cystic lymphangiomas of the neck (
hygroma colli) have traditionally been treated surgically or by local injection of various
sclerosing agents. Owing to the infiltrative growth of these
cysts, radical surgery has often been difficult due to the risk of damage to nerves and adjacent organs; and the use of available
sclerosing agents has often resulted in disfigurement due to extensive
scarring, thus rendering secondary surgery even more difficult. However,
OK-432, a new agent for local injection, has been tested with good results, especially in Japan. In five consecutive paediatric cases of
lymphangioma, we found ultrasound-guided injection of the
cysts with
OK-432 to yield good response without complications. In three cases, the
lymphangioma disappeared leaving the child's appearance quite normal, and there has been no recurrence. In one case, the
lymphangioma disappeared but apparently recurred within half a year (during which time we had lost contact with the family). This was the only case of small
cysts (
cavernous lymphangioma), which are putatively more resistant to
OK-432. The only child to be operated also had thoracic
lymphangioma which was not injected, though the cervical part which was injected was reduced by 50 per cent pre-operatively, the final outcome being excellent with no visible
cysts in any region. Thus, hitherto our results suggest the
therapeutic effect of
OK-432 to be good, and further clinical investigation is planned.