Doxycycline sclerotherapy as a primary treatment of head and neck giant cystic hygroma: A case report study.

Abstract

Introduction: Cystic hygroma is a benign lymphatic malformation, developing around 6th gestational week. The big challenge is in the way they are managed due to their extension within the vital elements. Treatment options include watchful waiting, surgery, sclerotherapy and combination between them in some cases.

Case presentation: We present a rare case of giant cystic hygroma of a 11-month-old male was referred to the Department of Otolaryngology for an asymptomatic, aesthetically unappealing swelling in the neck since 9 months. A well-defined large cystic mass measures about (4 × 7 × 9 cm) was seen in the CT scan, originating at the left lateral neck. It extends from the left submandibular space inferiorly posterior to the sternocleidomastoid muscle, and retrosternally to the aortic arch level. From the Posterior aspect, the mass reaches the prevertebral space. No lymph adenopathy was noted. No bony erosions. Findings are suggestive of Cystic Higroma (CH).The primary treatment was sclerotherapy using doxycycline for one time. The procedure was performed at an operating theatre under general anesthesia because injection of the sclerosant factor is painful. The child was monitored for 3 months after the procedure (with an interval of one month between each observation). There was a noticeable improvement after 4 weeks and the complete resolution of the cystic hygroma was observed 12 weeks after the initial procedure. During the monitoring period of 6 months, the lesion did not show any recurrence.

Clinical discussion: In this case of giant Cystic Higroma (CH) significantly decreased after using of Doxycycline sclerotherapy for one time only without the need to repeat the procedure more than once. So clinicians should be aware of this good treatment of (CH) because it offers minimal patient trauma and excellent outcomes.

Conclusion: Through the good results we have reached from this case, we encourage its application extensively in the future to more cases due to their safety and quick results.