A 1-month-old child presented with cystic hygroma measuring 14 cm x10 cm on the left side of neck. Injection bleomycin was injected into the swelling after aspirating it completely with a wide bore needle. The aspirate was straw colored. The patient was discharged on the next day. At one month follow-up, it was completely regressed with only minor skin pigmentations and redundant skin (Fig 1, 2).
Figure 1: Cystic hygroma
Figure 2: After 1 month of single session sclerotherapy.
DISCUSSION
Macrocystic lymphangioma which was previously known as cystic hygroma is a congenital malformation of the lymphatic system. Complete surgical excision is preferred but as there is risk of damage to vital structures it is largely superseded by intralesional sclerotherapy.[1-2] Complete resolution of cystic hygroma with injection bleomycin can be achieved in about 60% of cases and requires multiple sclerotherapy sessions. Very rarely, the complete resolution is achieved in a single session as happened in our case.
Footnotes
Source of Support: Nil
Conflict of Interest: None declared
References
- 1. Ibrahim AH, Kandeel A, Bazeed MF. Successful non-surgical management of a huge life threatening cervicomediastinal cystic hygroma case report and review of the literature. J Pediatr Surg Specialt 2009;3:48-50. [Google Scholar]
- 2. doi: 10.4103/0189-6725.78937. Mirza B, Ijaz L, Iqbal S, Mustafa G, Saleem M, Sheikh A. Cystic hygroma of unusual sites: Report of two cases. Afr J Paediatr Surg. 2011;8:85-8. [DOI] [PubMed] [Google Scholar]