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Prenatal 2-D and 3-D Ultrasound Characteristics of a Case of Fetal Orofacial Macrocystic Lymphatic Malformation and its Postnatal Management with Intralesional Bleomycin. JOURNAL OF FETAL MEDICINE 2022. [DOI: 10.1007/s40556-022-00339-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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2
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Abbasi N, Ryan G. Fetal primary pleural effusions: Prenatal diagnosis and management. Best Pract Res Clin Obstet Gynaecol 2019; 58:66-77. [PMID: 30737016 DOI: 10.1016/j.bpobgyn.2019.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 02/07/2023]
Abstract
Fetal pleural effusions can be associated with significant perinatal morbidity and mortality. When diagnosed antenatally, referral to a tertiary fetal medicine center is recommended for a detailed ultrasound evaluation for additional structural abnormalities or features suggestive of congenital infections or fetal anemia. The effusions should be characterized as unilateral or bilateral, and presence of hydrops and/or mediastinal shift should be documented. Additional testing should include fetal echocardiography, maternal testing for blood group and screen, hemoglobinopathies, and congenital infections. Invasive genetic testing is recommended with infectious testing on amniotic or pleural fluid. Pleuroamniotic shunting is recommended for large primary pleural effusions with significant mediastinal shift or hydrops, as several large series have demonstrated improvement in perinatal survival, particularly in hydropic fetuses. Delivery should occur in a tertiary care center with neonatal expertise, and infants should be followed up long-term for respiratory and neurodevelopmental outcomes.
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Affiliation(s)
- Nimrah Abbasi
- Fetal Medicine Unit, Department of Obstetrics & Gynaecology, Mount Sinai Hospital, University of Toronto, Canada.
| | - Greg Ryan
- Fetal Medicine Unit, Department of Obstetrics & Gynaecology, Mount Sinai Hospital, University of Toronto, Canada.
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3
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Abstract
Introduction: Lymphangiomas are very rare benign tumors of the lymphatic system, appearing as uniseptate or multiseptate cystic masses, which are usually located in the cervical or axillary area. Postnatal outcome depends on the size and location of the lesion. An increasing number of such congenital abnormalities are detected on routine conventional prenatal ultrasonography. Although prenatal evaluation for the prognosis of fetal lymphangioma has been based on two-dimensional ultrasonography, magnetic resonance imaging may help in assessing the extent of a lesion. Isolated lymphangiomas generally have a favourable prognosis and sclerotherapy or surgical resection is effective in most of the cases. Case presentation: We present two cases of fetal axillary lymphangioma. In the first case, the lymphangioma was diagnosed antenatally, so parents were comprehensively counselled and post natal follow up was organised at a tertiary hospital. The second case remained undiagnosed until birth. This caused significant distress to both the parents and clinicians, especially after a coincident traumatic delivery. Conclusion: Both these cases emphasise that early diagnosis of fetal lymphangioma is critical and a combination of ultrasonography and magnetic resonance imaging can facilitate detection of lesions which are relatively limited and accessible to therapy in utero. This would also enable clinicians to perform a karyotype and comprehensively consult parents regarding the treatment and delivery options as well as outcome of the pregnancy.
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Affiliation(s)
| | - Alka Kothari
- Redcliffe Hospital Redcliffe Queensland Australia
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Odibo IN, Linam LE, Richter GE, Jackson RJ, Dajani NK. Extensive Fetal Congenital Subcutaneous Mixed Venous Lymphatic Lesion: Prenatal Diagnosis and Postnatal Management. AJP Rep 2015; 5. [PMID: 26199796 PMCID: PMC4502633 DOI: 10.1055/s-0034-1544107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Vascular lesions may be categorized as proliferative tumors, such as hemangiomas, or nonproliferative malformations that include capillary, lymphatic, venous, arterial, or mixed lesions. Lymphatic malformations are benign localized congenital malformations of the lymphatic system. They may be microcystic or macrocystic lesions or a combination of both. The lesions may also be uniseptate or multiseptate, and are more commonly located in the head and neck or axillary region. Prenatal diagnosis is based on ultrasound and magnetic resonance imaging. Postnatal management largely depends on the size and location of the lesion. This is the first case report of prenatally diagnosed extensive subcutaneous macrocystic venous lymphatic malformation involving the fetal thorax, back, pelvis, and lower extremities. Prenatal course and postnatal management are described. This report will aid other specialists in the field of prenatal diagnosis and postnatal surgery in the evaluation and management of these patients.
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Affiliation(s)
- I N Odibo
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Arkansas
| | - L E Linam
- Department of Radiology, Arkansas Children's Hospital, Arkansas
| | - G E Richter
- Department of Otolaryngology, Arkansas Children's Hospital, Arkansas
| | - R J Jackson
- Department of Otolaryngology, Arkansas Children's Hospital, Arkansas
| | - N K Dajani
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Arkansas
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5
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Abstract
With modern cross-sectional imaging techniques, cystic lesions are very common and usually incidental findings, especially if small. However, when cysts enlarge, become infected, bleed, or undergo torsion, they can be symptomatic, and percutaneous drainage can be effective in the management. When cysts recur after aspiration, which is often the case for hepatic and renal cysts, cyst sclerosis or surgical unroofing may be required. This article describes the indications for and technical aspects of percutaneous sclerotherapy of cystic lesions of multiple organ systems.
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Affiliation(s)
- Danny Cheng
- University of California - Davis Medical Center, Sacramento, California
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6
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Gedikbasi A, Oztarhan K, Aslan G, Demirali O, Akyol A, Sargin A, Ceylan Y. Multidisciplinary approach in cystic hygroma: prenatal diagnosis, outcome, and postnatal follow up. Pediatr Int 2009; 51:670-7. [PMID: 19419502 DOI: 10.1111/j.1442-200x.2009.02846.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of the present study was to determine prenatal follow up and clinical outcome in fetuses born with cystic hygroma. METHODS A series of 64 cystic hygroma patients, who were diagnosed in the first and the second trimester of pregnancy, was enrolled. Associated structural abnormalities, karyotype analysis and pregnancy outcome were studied. Survivors were followed for their fetal outcome and prognosis. RESULTS There were 64 new cases of cystic hygroma in 8524 subjects screened (0.75%). Thirty-nine (60.9%) were of non-septated and 25 (39.1%) were of septated cystic hygroma. Chromosomal abnormalities were present in 25 (39.1%). The most common abnormality in non-septated cystic hygroma was trisomy 21 (10, 27.8%), and that in septated cystic hygroma was Turner syndrome (5, 23.8%). Associated structural malformations are common in cystic hygroma and overall survival was poor. Nine of the present infants were live-born and were subsequently followed up. Two had cardiac pathology and died after cardiac operation, two others were diagnosed with axillary cystic hygroma, had an excellent prognosis and responded well to treatment, and another two had cranial findings with mild neurological sequel. Only three cases had, at birth and in the follow-up period, no complications. CONCLUSION Cystic hygroma is highly correlated with adverse perinatal outcome. Prenatal diagnosis and invasive procedures are vital for counselling with close follow-up after delivery for appropriate medical support. A multidisciplinary approach is strictly recommended in live-born children.
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Affiliation(s)
- Ali Gedikbasi
- Department of Obstetrics and Gynecology, Istanbul Bakirkoy Maternity and Children's Diseases Hospital, Istanbul, Turkey.
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7
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Abstract
Cystic lesions are frequently occurring diseases of the head and neck region. Complete surgical resection near to neurovascular structures can be accompanied by various complications. In selected cases intralesional injection of OK-432 could constitute an alternative. The average success rate of sclerotherapy of lymphatic malformations is 60%. Side effects are rare. Sclerotherapy is a minimally invasive, simple and cost-effective procedure performed without general anaesthesia at the outpatient clinic. Nerve lesions or troublesome scarring do not occur. In residual cases surgical excision is realisable without any difficulty. Repeated injections of sclerotherapy agents represent a disadvantage. Abscess formation has been observed as a rare complication. A malignant disease has to be excluded by cytological examination before commencing sclerotherapy. The intracystic injection of OK-432 is an effective treatment modality for cystic cervical lesions.
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Abstract
OBJECTIVE To review the diagnosis, management, and treatment options of tumors presenting during fetal development. METHODS Recognized textbooks and peer-reviewed literature (from the years 1985-2006) were summarized for the most common information on fetal tumors. RESULTS Fetal tumors are rare, with a usual prevalence of less than 1 in 10,000 live births. The list of fetal tumors reviewed includes tumors involving multiple sites, such as teratoma, lymphangioma, and hemangioma, and tumors located specifically in organs such the liver, adrenal gland, kidney, and placenta. CONCLUSIONS Prenatal diagnosis, surveillance, and treatment of fetal tumors is limited to case reports, small series, and single-institution experience.
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Affiliation(s)
- R Douglas Wilson
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Pennsylvania, USA.
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9
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Abstract
OBJECTIVE To evaluate OK-432, a preparation of Streptococcus pyogenes, in the treatment of early fetal chylothorax. METHODS A prospective study of all fetuses (n=7) with persistent early chylothorax (gestational ages 16-21 weeks) referred to the tertiary center of fetal medicine in Denmark in 2003-2005. Fetuses were injected with 0.2-1.0 mg of OK-432 into the pleural cavity. The treatment was repeated if there were persistent or increasing pleural effusions after 1-3 weeks. The main outcome measures included remission of pleural effusions and fetal and infant morbidity and mortality. RESULTS Total remission of pleural effusions was obtained in all fetuses after one or two intrapleural injections of OK-432. No adverse effects of the treatment were observed. No fetus developed hydrops, and all experienced an uncomplicated third trimester. All children were born healthy without pleural effusions, lung hypoplasia, or hydrops. CONCLUSION Persistent early chylothorax is a condition with a high mortality rate and no established treatment option. Use of OK-432 is a promising therapy for selected fetuses with persistent chylothorax early in the second trimester.
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Affiliation(s)
- Ulrikka Nygaard
- Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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10
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Ogita K, Taguchi T, Suita S. Experimental Study Concerning Safety Dosage of OK-432 for Intrauterine Treatment. Asian J Surg 2006; 29:202-6. [PMID: 16877226 DOI: 10.1016/s1015-9584(09)60088-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Clinical intrauterine treatment for fetal cystic hygroma has so far been performed in a few patients; however, it is still difficult to evaluate the results. The aim of this study is to establish the safe dosage of OK-432 in the intrauterine treatment of fetal cystic hygroma. METHODS OK-432 was injected either subcutaneously behind the neck of the fetuses or into the amniotic cavity through the uterine wall of pregnant Japanese white rabbits at 27 days of gestation. Saline was administered to the controls. The dosage and the site of injection were as follows: group 1, OK-432, 0.01 KE (0.25 KE/kg) in 0.2 mL saline per fetus, subcutis; group 2, OK-432, 0.02 KE (0.5 KE/kg) in 0.2 mL saline per fetus, subcutis; group 3, OK-432, 0.04 KE (1 KE/kg) in 0.2 mL saline per fetus, subcutis; group 4, OK-432, 0.01 KE in 0.2 mL saline per fetus, amniotic cavity; group 5, OK-432, 0.04 KE in 0.2 mL saline per fetus, amniotic cavity; group 6, saline, 0.2 mL per fetus, subcutis; group 7, saline, 0.2 mL per fetus, amniotic cavity. All fetuses were delivered at 29 days of gestation. RESULTS The mother's rectal temperature was mostly in the normal range throughout the experiment. There was no significant difference between any of the seven groups in fetal body weight. The C reactive protein values of all fetuses were negative. The appearance of the skin of all the fetuses was normal. The histopathological findings of the skin in the OK-432 groups showed a moderate infiltration of monocytes and plasma cells. No pathological changes were observed in the heart, lung, liver or kidneys of any of the fetuses. CONCLUSION Based on this rabbit experiment, we determined that OK-432 may be safely used at a dose of up to 1 KE/1 kg of fetal body weight as an intrauterine treatment for fetal cystic hygroma.
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Affiliation(s)
- Keiko Ogita
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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11
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Chen M, Chen CP, Shih JC, Chou HC, Yu CL, Wang BT, Hsieh CY. Antenatal Treatment of Chylothorax and Cystic Hygroma with OK-432 in Nonimmune Hydrops fetalis. Fetal Diagn Ther 2005; 20:309-15. [PMID: 15980647 DOI: 10.1159/000085092] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2004] [Accepted: 09/28/2004] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To present our experience of using OK-432 in treating fetal cystic hygroma and chylothorax complicated with nonimmune hydrops fetalis. METHODS OK-432 (Picibanil) was injected into the fetal pleural cavity or fetal cystic hygroma. RESULTS Patient 1: A 23-year-old, gravida 2, para 1, was found to have a recurrent fetal chylothorax at GA 29 weeks. Serial amnioreduction and thoracocentesis was performed at GA 31, 32, 33, and 34 weeks. Intrapleural OK-432 injection was performed twice at GA 33 and 34 weeks. Cyanosis and respiratory distress were noted immediately after birth (GA 34 weeks). The baby expired despite of aggressive neonatal resuscitation. Patient 2: A 26-year-old, gravida 2, para 1, was found to have a cystic hygroma of her fetus at GA 17 weeks. Karyotype of the cystic fluid and the amniocytes were 46, XY. Fetal ascites developed at GA 22 weeks. OK-432 injection into the tumour was performed at GA 23 weeks. Stabilization of the cystic hygroma was noted throughout the pregnancy (about 3.5 cm in diameter). Serial fetal paracentesis and/or amnioreduction were performed. Karyotype of the ascites was again 46, XY. Maternal dietary modification with medium chain triglyceride was also prescribed. Chylothorax developed and the baby was born by cesareans at GA 32 weeks. Resolution of pleural effusion, ascites, and regression of cystic hygroma were noted since the 2nd day after birth. The baby had survived beyond 4 months of age at submission. CONCLUSION Combination of antenatal OK-432 injection, maternal dietary modification, serial thoracocentesis plus paracentesis, together with amnioreduction and tocolysis, appeared to contribute to the success of antenatal treatment. Fetal pulmonary expansion may determine the immediate neonatal survival.
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Affiliation(s)
- Ming Chen
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan.
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Rha SE, Byun JY, Kim HH, Shin JC, Ahn HY, Kim DC, Lee KY. Prenatal sonographic and MR imaging findings of extensive fetal lymphangioma: a case report. Korean J Radiol 2004; 4:260-3. [PMID: 14726645 PMCID: PMC2698106 DOI: 10.3348/kjr.2003.4.4.260] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We report the imaging findings in a case of fetal lymphangioma involving the retroperitoneum and right lower extremity, and diagnosed by ultrasonography and magnetic resonance (MR) imaging at 26 weeks of gestation. Prenatal ultrasonograms and T2-weighted single-shot fast spin-echo MR images clearly revealed an extensive, multilocular cystic mass with internal hemorrhage in the retroperitoneum extending to the lower extremity.
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Affiliation(s)
- Sung Eun Rha
- Department of Radiology, The Catholic University of Korea, College of Medicine, Seoul, Korea.
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Mostofian E, Ornvold K, Latchaw L, Harris RD. Prenatal sonographic diagnosis of abdominal mesenteric lymphangioma. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2004; 23:129-132. [PMID: 14756361 DOI: 10.7863/jum.2004.23.1.129] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- Eimaneh Mostofian
- Department of Pathology, Dartmouth Medical School, Lebanon, New Hampshire, USA
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15
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Chen CP. Congenital retroperitoneal cystic teratoma mimicking a cystic lymphangioma on perinatal ultrasound. Prenat Diagn 2003; 23:763-5. [PMID: 12975791 DOI: 10.1002/pd.664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Fukase S, Ohta N, Inamura K, Aoyagi M. Treatment of ranula wth intracystic injection of the streptococcal preparation OK-432. Ann Otol Rhinol Laryngol 2003; 112:214-20. [PMID: 12656411 DOI: 10.1177/000348940311200304] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Intracystic injection of OK-432 was developed as a therapy for operatively difficult lymphangioma (cystic hygroma) and is currently becoming a treatment of first choice for this disease. We tried this therapy in 32 patients with ranula (oral floor type in 21 cases and plunging type in 11 cases). Disappearance or marked reduction of the lesion was observed in 31 patients (97%) who had this therapy, and local scarring did not occur in any patient. As side effects, local pain at the injection site and fever (37 degrees C to 39 degrees C) were observed in almost half of the patients who had this therapy, but such problems resolved within a few days. We treated the initial 4 cases in the hospital for 4 to 5 days, but after the safety of this method had been confirmed, we treated the other 28 cases on an outpatient basis. Thus, we confirmed that intracystic injection therapy with OK-432 is relatively safe and can be used as a substitute for surgery in the treatment of ranulas.
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Affiliation(s)
- Shigeru Fukase
- Department of Otorhinolaryngology, Yamagata University School of Medicine, Yamagata, Japan
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17
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Hall N, Ade-Ajayi N, Brewis C, Roebuck DJ, Kiely EM, Drake DP, Spitz L, Pierro A. Is intralesional injection of OK-432 effective in the treatment of lymphangioma in children? Surgery 2003; 133:238-42. [PMID: 12660633 DOI: 10.1067/msy.2003.62] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Intralesional injection of OK-432 has been proposed as an effective treatment of lymphangioma. The aim of this study was to review our experience with OK-432 injection of lymphangioma and to identify factors associated with successful outcome. METHODS We made a case note review of 19 children who received OK-432 injection. Median duration of follow-up was 17 months. RESULTS Lesions were diagnosed antenatally in 4 children, at birth in 4 children, and between 1 month and 11 years in the remainder. Anatomic locations were head/neck in 14, axilla in 1, and multiple locations in 4. Median number of injections per child was 2 (range, 1 to 5). Disappearance of the lesion was achieved after OK-432 injection in 2 patients (11%) and a marked reduction in 5 (26%); all these lesions were in the head and neck. Lesions larger than 5 cm and those outside the head and neck region did not respond well to OK-432 injection. Fourteen children (74%) required surgical excision after injection. Complications of OK-432 injection included partial tracheal obstruction, fever, local inflammatory response, and abscess formation. CONCLUSIONS OK-432 injection was effective in approximately one third of children with lymphangioma. Lesions outside the head and neck and those larger than 5 cm are unlikely to respond to this therapy. Injection of lymphangioma surrounding the airways may be hazardous.
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Affiliation(s)
- Nigel Hall
- Department of Paediatric Surgery, Institute of Child Health and Great Ormond Street Hospital for Children, London, UK
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18
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Jorgensen C, Brocks V, Bang J, Jorgensen FS, Rønsbro L. Treatment of severe fetal chylothorax associated with pronounced hydrops with intrapleural injection of OK-432. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2003; 21:66-69. [PMID: 12528165 DOI: 10.1002/uog.23] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We describe a case of a 25-week fetus with severe bilateral pleural effusion, marked ascites, skin edema, an anterior thick (hydropic) placenta and polyhydramnios in which the most probable diagnosis was congenital chylothorax. Treatment with a pleuroamniotic shunt was planned, however the location of the fetus just below the anterior placenta made the placement of the shunt too dangerous. We therefore decided to use intrapleural injection of OK-432. From week 29, the lungs looked normal, the pleural effusion had resolved and the thoracic circumference was within normal limits. The severe ascites persisted throughout the pregnancy and a total volume of 3680 mL was removed on several occasions. A Cesarean section was performed at 38 weeks and a normal male was delivered. Continuous positive airway pressure was needed on the first 4 days but after a week the situation was stable. On day 8, an X-ray showed normally developed lungs. OK-432 appears to have prevented pulmonary hypoplasia in our patient.
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Affiliation(s)
- C Jorgensen
- Department of Fetal and Maternal Ultrasound, The Juliane Marie Centre for Children, Women and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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Giguère CM, Bauman NM, Smith RJH. New treatment options for lymphangioma in infants and children. Ann Otol Rhinol Laryngol 2002; 111:1066-75. [PMID: 12498366 DOI: 10.1177/000348940211101202] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Lymphangiomas are congenital malformations of the lymphatic system. These lesions occur most often in the head and neck area, and their treatment continues to be a challenge. Fortunately, a number of advances have occurred in the diagnosis and management of lymphatic malformations in the past decade. The purpose of this article is to clarify the embryology, pathogenesis, histopathology, and classification of these lesions, as well as to describe their various forms of clinical presentation. We provide a complete review of the diagnostic measures available and thoroughly discuss new therapeutic interventions proposed to treat lymphangiomas.
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Affiliation(s)
- Chantal M Giguère
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA
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20
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Watanabe N, Hosono T, Chiba Y, Kanagawa T. Outcomes of Infants with Nonimmune Hydrops Fetalis Born after 22 Weeks' Gestation — Our Experience between 1982 and 2000. J Med Ultrasound 2002. [DOI: 10.1016/s0929-6441(09)60026-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Okawa T, Takano Y, Fujimori K, Yanagida K, Sato A. A new fetal therapy for chylothorax: pleurodesis with OK-432. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2001; 18:376-377. [PMID: 11778999 DOI: 10.1046/j.0960-7692.2001.00556.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We present a case of pleurodesis by intrapleural injection of OK-432 for the treatment of fetal chylothorax at an early gestational age. OK-432 injection achieved rapid and effective control of pleural effusion with no adverse effects.
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Affiliation(s)
- T Okawa
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Japan.
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22
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Sun N, Chan KL. OK-432 (Picibanil) therapy for lymphangioma: Collective experience in the literature. ACTA ACUST UNITED AC 2001. [DOI: 10.1046/j.1442-2034.2001.00083.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Deshpande P, Twining P, O'Neill D. Prenatal diagnosis of fetal abdominal lymphangioma by ultrasonography. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2001; 17:445-448. [PMID: 11380973 DOI: 10.1046/j.1469-0705.2001.00367.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We present a case of abdominal lymphangioma in a fetus together with a review of the literature. Diagnosis was made at 20 weeks' gestation by antenatal ultrasonography. In keeping with other reports, the lesion was located on the left and serial ultrasonography demonstrated rapid growth with extension into the lower extremity.
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Affiliation(s)
- P Deshpande
- Department of Obstetrics and Gynaecology, Queen's Medical Centre, Castle Boulevard, Nottingham NG7 2UH, UK
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24
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Mehta MR. Cystic hygroma: Presentation of two casfes with a review of the literature. Indian J Otolaryngol Head Neck Surg 2000; 52:319-22. [PMID: 23119712 PMCID: PMC3451102 DOI: 10.1007/bf03006220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Two interesting cases of cystic hygroma are being reported. One presented with dyspneoa and the other one with macroglosia and mediastinal cystic hygroma. The foetal chromosomal anomalies associated with cystic hygroma, intrauterine diagnosis and treatment of cystic hygroma as well as pathogenesis, classification, surgical and non-surgical management of cystic hygroma has been discussed in detail in the review of the literature.
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Affiliation(s)
- M R Mehta
- Govt. Medical College, Rajkot, Gujarat
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25
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Brewis C, Pracy JP, Albert DM. Treatment of lymphangiomas of the head and neck in children by intralesional injection of OK-432 (Picibanil). CLINICAL OTOLARYNGOLOGY AND ALLIED SCIENCES 2000; 25:130-4. [PMID: 10816217 DOI: 10.1046/j.1365-2273.2000.00338.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The treatments previously used for lymphangiomas of the head and neck in children-surgery and intralesional injection of sclerosants-are associated with significant morbidity. A new treatment-intralesional injection of OK-432-was used for lymphangiomas of the head and neck in 11 children. The results were total shrinkage in two, marked shrinkage in two, slight shrinkage in five and no response in two. The results were not affected by previous surgery nor by whether aspiration prior to injection was possible. There were no recurrences in those children in whom shrinkage occurred and no child had subsequent surgery following injection. The results of this series support those of previous series showing that OK-432 injection is an effective and safe treatment for lymphangiomas of the head and neck in children.
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Affiliation(s)
- C Brewis
- Department of ENT Surgery, Great Ormond Street Hospital for Children, NHS Trust, Great Ormond Street, London, UK
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Abstract
Hemangiomas are the most common neoplastic growth affecting the pediatric airway. The expected natural history includes a period of rapid growth followed by spontaneous involution. These patients often require treatment of the hemangioma in order to avoid the consequences of airway obstruction. In contrast, vascular malformations do not undergo spontaneous resolution. The clinical course and treatment options for children with vascular malformations are quite different from those with hemangioma. The clinical presentation, evaluation, management options, and expected outcomes for both of these lesions are discussed in this article.
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Affiliation(s)
- K C Sie
- Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington 98105, USA
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27
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Abstract
Cystic hygromas are developmental abnormalities of the lymphoid system that occur at sites of lymphatic-venous connection, most commonly in the posterior neck. They are frequently associated with karyotypic abnormalities, various malformation syndromes, and several teratogenic agents. The disease course of an infant with cystic hygroma is unpredictable. When diagnosed prenatally, the overall prognosis is poor. Cystic hygroma diagnosed after birth is usually associated with a good prognosis. This article reviews the embryologic, genetic, and pathologic correlates of these lymphatic system abnormalities, as well as the clinical course and outcome of the fetus and newborn with a cystic hygroma. Management strategies are reviewed, including newer nonsurgical therapies for the neonate with a cystic hygroma.
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Affiliation(s)
- P G Gallagher
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520-8064, USA.
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