Giant Cervico-Thoraco-Brachial Cystic Lymphatic Malformation in an Infant: Therapeutic Strategy
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Cystic lymphatic malformations (CLMs) are rare benign congenital vascular malformations characterized by slow flow and composed of abnormal cystic dilations. The most widely used classification divides them into microcystic, macrocystic, and mixed lesions. Ultrasound is the preferred initial evaluation tool for CLMs due to its non-irradiating nature and accessibility. MRI is used to classify CLMs before considering therapeutic management. Biopsy and fine needle aspiration are rarely needed to diagnose CLMs. The progression of CLMs is marked by asymptomatic periods interspersed with painful inflammatory flare-ups. Surgical treatment remains the gold standard for managing these malformations. This paper reports our experience in treating a case of giant cervico-thoraco-brachial cystic lymphatic malformation in a 4-month-old infant.
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1. Sjogren PP, Arnold RW, Skirko JR, Grimmer JF (2017) Anatomic distribution of cervicofacial lymphatic malformations based on lymph node groups. Int J Pediatr Otorhinolaryngol 97: 72-75.
2. Hogeling M, Adams S, Law J, Wargon O (2011) Lymphatic malformations: Clinical course and management in 64 cases. Australas J Dermatol 52:186-190.
3. Wiegand S, Eivazi B, Barth PJ, von Rautenfeld DB, Folz BJ, et al. (2008) Pathogenesis of lymphangiomas. Virchows Arch 453: 1 8.
4. Wassef M, Blei F, Adams D, Alomari A, Baselga E, et al. (2015) Vascular anomalies classification: Recommendations from the international society for the study of vascular anomalies. Pediatrics. 136: e203-214.
5. Miloundja J, Manfoumbi Ngoma AB, Mba Ella R, Nguema Edzang B, N'Zouba L (2007) Cystic cervicofacial lymphangioma in children in Gabon. Ann Otolaryngol Chir Cervico-Faciale. 124: 277-84.
6. (2021) Protocole National de Diagnostic et de Soins (PNDS) MALFORMATIONS LYMPHATIQUES KYSTIQUES.
7. Lerat J, Bisdorff-Bresson A, Borsic M, Chopinet C, Couloignier V, et al. (2019) Guidelines (short version) of the French Society of Otorhinolaryngology (SFORL) on cervical lymphatic malformation in adults and children: Diagnosis. Eur Ann Otorhinolaryngol Head Neck Dis 136: 110-114.
8. Perkins JA, Manning SC, Tempero RM, Cunningham MJ, Edmonds JL, et al. (2010) Lymphatic malformations: Review of current treatment. Otolaryngol Neck Surg 142: 795-803.
9. Wierzbicka E, Herbreteau D, Robert M, Lorette G. (2006) Malformations lymphatiques kystiques. Ann Dermatol Venereol 133: 597-601.
10. Heit JJ, Do HM, Prestigiacomo CJ, Delgado-Almandoz JA, English J, et al. (2017) Guidelines and parameters: percutaneous sclerotherapy for the treatment of head and neck venous and lymphatic malformations. J Neurointerv Surg 9: 611-617.
11. Iacobas I, Adams DM, Pimpalwar S, Phung T, Blei F, et al. (2020) Multidisciplinary guidelines for initial evaluation of complicated lymphatic anomalies-expert opinion consensus. Pediatr Blood Cancer 67: e28036.
12. Phang MJ, Courtemanche DJ, Bucevska M, Malic C, Arneja JS (2017) Spontaneously resolved macrocystic lymphatic malformations: Predictive variables and outcomes. Plast Surg 25: 27 31
13. Perkins JA, Maniglia C, Magit A, Sidhu M, Manning SC, et al. (2008) Clinical and radiographic findings in children with spontaneous lymphatic malformation regression. Otolaryngol Head Neck Surg 138: 772-777
14. Horbach SER, Lokhorst MM, Saeed P, de Goüyon Matignon de Pontouraude CMF, Rothová A, et al. (2016) Sclerotherapy for low- flow vascular malformations of the head and neck: A systematic review of sclerosing agents. J Plast Reconstr Aesthet Surg 69: 295 304.
15. Tu JH, Do HM, Patel V, Yeom KW, Teng JMC (2017) Sclerotherapy for lymphatic malformations of the head and neck in the pediatric population. J Neurointerv Surg 9: 1023 6.
16. Lisan Q, Villepelet A, Parodi M, Garabedian E-N, Blouin MJ, et al. (2016) Value of radiofrequency ablation in the management of retropharyngeal lymphatic malformation. Int J Pediatr Otorhinolaryngol 83: 37-40.
17. Balakrishnan K, Menezes MD, Chen BS, Magit AE, Perkins JA (2014) Primary surgery vs primary sclerotherapy for head and neck lymphatic malformations. JAMA Otolaryngol Head Neck Surg 140: 41 5.
18. Alqahtani A, Nguyen LT, Flageole H, Shaw K, Laberge J-M (1999) 25 Years´ experience with lymphangiomas in children. J Pediatr Surg 34: 1164-8.
19. Handa R, Kale R, Upadhyay KK (2004) Isolated mediastinal lymphangioma herniating through the intercostal space. Asian J Surg 27: 241-2.
20. Martinez-Corral I, Zhang Y, Petkova M, Ortsäter H, Sjöberg S, et al. (2020) Blockade of VEGF-C signaling inhibits lymphatic malformations driven by oncogenic PIK3CA mutation. Nat Commun 11: 2869.
Copyright (c) 2025 Pr Mohamed Djelad, Karima Lalaoui, Riad Sekkal, Rachid Ouslim
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