Ghulam Mustafa, Bilal Mirza, Sarfraz Ahmad, Nabila Talat, Muhammad Saleem, Afzal Sheikh.
Outcome of Intra-Lesional Bleomycin in the Management of Cystic Hygroma.
Pak Paed J Jan ;42(4):261-5.

Background: Cystic hygroma or macrocystic lymphatic malformation commonly occurs at cervico-facial region and used to be treated with surgical excision. Now studies have documented superior results with sclerotherapy. Objective: To study the outcome of treatment with Intra-lesional bleomycin in the patients of cystic hygroma. Study design: A prospective case series. Setting: This study was conducted in the Pediatric Surgery Department, The Children?s Hospital & the Institute of Child Health Lahore. Material and Methods: Forty five patients of cystic hygroma in whom sclerotherapy was advised were enrolled. Inj bleomycin was injected intra-lesionally at a dose of 0.3mg/kg of body weight and number of sclerotherapy sessions ranged from 1 to 4 per patient. The sessions were repeated monthly and the size of the lesion was noted before each sclerotherapy session. The data was analyzed using SPSS version 20. Results: There were total 45 patients including 30 males and 15 females (M:F 1:0.5) having age range 1month to 12 years. Thirty patients (66.7%) showed complete resolution and 12 patients (26.7%) showed good response and 3 patients (6.7%) showed poor response and none of the patients showed no response. One patient showed complete resolution after 2 sessions of bleomycin; whereas, 12 patients showed complete resolution after three sessions of bleomycin, and 17 patients showed complete resolutions after 4 sessions of bleomycin. No serious/lethal side effects were observed. Conclusion: Bleomycin is effective and reliable for macro-cystic lymphatic malformations. There are no long term lethal side effects. It should be considered as primary therapy for cystic hygroma.

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