Outcome of Injection Sclerotherapy With Doxycycline in Lymphatic, and Veno-lymphatic Malformation in Children: A Single Centre Experience.

Aim: Lymphatic malformations (LMs) and Veno-lymphatic malformations (VLMs) are congenital slow flow vascular malformations. Intralesional sclerotherapy is a good alternate option for treatment of LMs and VLMs. Our aim was to evaluate the outcome of doxycycline sclerotherapy for lymphatic and veno-lymphatic malformation in children in our institute.

Methods: Retrospectively review of children with LMs or VLMs, primarily treated with doxycycline sclerotherapy in our hospital from January 2012 to December 2023. Patient's demographics, type and location of lesion, number of sclerotherapy sessions, final outcome and complications were recorded and data was analyzed. The clinical response was deemed excellent if lesion resolved completely (>90 % resolution) and satisfactory if there was >50 % resolution of lesion based on visual estimate. The response was considered as poor if <50 % resolution of lesion.

Results: Out of 70 patients, 34 (48 %) patients had lesion located in cervicofacial region. 164 sessions were required (range 1-7/patient). 47/70 (68 %) patients showed excellent response, 9/70 (12 %) patients showed satisfactory response and remaining 14/70 (20 %) patients showed poor response. 8 patients (11 %) required subsequent surgery after sclerotherapy. Sclerotherapy with doxycycline was successful in 80 % of patients. No major complication was noted in any patient.

Conclusion: Doxycycline sclerotherapy resulted in excellent clinical outcome and complete resolution of lesions in majority of cases without increased need for subsequent surgical resection. Doxycycline is a readily available and cost effective treatment option with minimum side effects. It should be considered as a primary treatment for LM and VLM in children.