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Doxycycline sclerotherapy in children with lymphatic malformations: outcomes, complications and clinical efficacy

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Abstract

Background

Lymphatic malformations (LMs) are congenital lesions of the lymphatic system and consist of lymphatic channels and cystic spaces of varying sizes. Recent evidence has shown that LMs respond well to intralesional sclerotherapy.

Objective

The purpose of this retrospective study is to evaluate the outcome and efficacy of using doxycycline in treating macrocystic, microcystic and combined macro- and microcystic LMs in a tertiary-care pediatric center.

Materials and methods

Fifty children (32 boys, 18 girls) underwent doxycycline sclerotherapy for treatment of LMs between January 2005 and October 2010. Demographics, imaging, doxycycline treatment details, complications and follow-up details were documented.

Results

The mean age at first treatment was 5.9 years (3 days–17.8 years), median 4.2 years. Cervicofacial (19/50 children) and truncal (16/50 children) locations were the most frequently affected. One hundred forty-six sclerotherapy sessions were performed in 50 children (mean 2.9/child). The mean doxycycline dose/kg body weight for 146 sessions was 15.3 mg/kg (0.6–85.7 mg/kg). Complications occurred in 4/146 procedures. Clinical follow-up showed excellent response in 14/16 children with macrocystic LMs, 21/27 children with combined LMs and 4/7 children with microcystic LMs.

Conclusion

Doxycycline is a safe and effective sclerosant agent for treating LMs in children, with a low complication rate.

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Authors and Affiliations

  1. Department of Diagnostic Imaging, Division of Image Guided Therapy, The Hospital for Sick Children, University of Toronto, 555 University Ave., Toronto, M5G 1X8, Canada

    Arvind Shergill, Philip John & Joao G. Amaral

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  1. Arvind Shergill
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  2. Philip John
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  3. Joao G. Amaral
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Correspondence to Joao G. Amaral.

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Shergill, A., John, P. & Amaral, J.G. Doxycycline sclerotherapy in children with lymphatic malformations: outcomes, complications and clinical efficacy. Pediatr Radiol 42, 1080–1088 (2012). https://doi.org/10.1007/s00247-012-2406-2

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  • DOI: https://doi.org/10.1007/s00247-012-2406-2

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