A clinical case of surgical treatment of lymphangioma at a difcult anatomical location in a 2-year-old child



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Abstract

Introduction. Lymphatic malformations are relatively rare in childhood. Their occurrence depends on age and varies between 1/600000 to 1/2500000. By literature data , the only radical curative option for this pathology is surgery; however, the relapse rate amounts to 25%. Therefore, further studies on the management of this pathology are needed.

Purpose. to present a rare clinical case of successful surgical treatment of a child with lymphatic mesentery malformation of the small intestine.

Materials and methods. The authors discuss various approaches to therapy and surgical care; they also present modern literature data and discuss the relevance of sclerosing preparations for injections directly into the cystic cavity. A clinical case of 2-year-old child with lymphangioma of complex anatomical location is described. The authors analyze ways of surgical intervention, early postoperative course and correction of the developed complications.

Results. Follow-up data were analyzed; the obtained results confrm a radical type of the performed surgery without worsening the quality of life.

Conclusion. Lymphangiomas at diffcult anatomical locations require a special attention during examination and treatment; radical removal can be considered as an effective option for treating such children.

About the authors

I. V. Poddubniy

Federal Scientific and Clinical Center for Children and Adolescents of FMBA of Russia; A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Author for correspondence.
Email: fake@neicon.ru
ORCID iD: 0000-0002-9077-6990

115409, Moscow, Russian Federation

127473, Moscow, Russian Federation

Россия

V. O. Trunov

Federal Scientific and Clinical Center for Children and Adolescents of FMBA of Russia; Pirogov Russian National Research Medical University

Email: trunov2000@mail.ru
ORCID iD: 0000-0002-7568-4297

Vladimir О. Trunov – MD, Cand.Sc.(med), associate professor at the chair of pediatric surgery; Deputy Director

115409, Moscow, Russian Federation

117997, Moscow, Russian Federation

Россия

K. N. Tolstov

Federal Scientific and Clinical Center for Children and Adolescents of FMBA of Russia; A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Email: fake@neicon.ru
ORCID iD: 0000-0003-2412-414X

115409, Moscow, Russian Federation

127473, Moscow, Russian Federation

Россия

A. O. Mager

A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Email: fake@neicon.ru
ORCID iD: 0000-0002-2498-0184

127473, Moscow, Russian Federation

Россия

References

  1. Elbaaly H., Piché N., Rypens F., Kleiber N., Lapierre C. Dubois. Intraabdominal lymphatic malformation management in light of the updated International Society for the Study of Vascular Anomalies classifcation. J. Pediatr Radiol. 2021 May; 51(5): 760-72.
  2. Kronfli A.P., McLaughlin C.J., Moroco A.E., Grant C.N. Lymphatic malformations: a 20-year single institution experience. Pediatric Surgery International. 2021, 37(6): 783-90.
  3. Поддубный И.В., Рябов А.Б., Абрамян М.А., Трунов В.О., Козлов М.Ю., Топилин О.Г. и cоавт. Хирургическое лечение лимфангиом у детей: описание серии случаев. Онкопедиатрия. 2019; (1): 53-64.
  4. Rössler J., Baselga E., Davila V., Celis V., Diociaiuti A., El Hachem M. et. al., Severe adverse events during sirolimus “off-label” therapy for vascular anomalies. Pediatr Blood Cancer. 2021; 13: e28936.
  5. Gómez Sánchez A., Redondo Sedano J.V., Pérez Alonso V., Martí Carrera M.E., Baro Fernández M., Palencia Pérez S.I., et. al. Oral rapamycin: an alternative in children with complicated vascular abnormalities.Cir Pediatr. 2020; 33(4): 183-7.
  6. Triana P., Miguel M., Díaz M., Cabrera M., López Gutiérrez J.C. Oral Sirolimus: An Option in the Management of Neonates with Life-Threatening Upper Airway Lymphatic Malformations. Lymphat Res Biol. 2019; 17(5): 504-11.
  7. Bouwman F.C.M., Kooijman S.S., Verhoeven B.H., Schultze Kool L.J., van der Vleuten C.J.M., Botden S.M.Bi., de Blaauw I. Lymphatic malformations in children: treatment outcomes of sclerotherapy in a large cohort. Eur J Pediatr. 2021 Mar; 180(3): 959-66.
  8. Markovic J.N., Nag U., Shortell C.K. Safety and effcacy of foam sclerotherapy for treatment of low-flow vascular malformations in children. J Vasc Surg Venous Lymphat Disord. 2020; 8(6): 1074-82.
  9. Gibson C.R., Barnacle A.M. «Vascular anomalies: special considerations in children. CVIR Endovasc. 2020: 22; 3(1): 60.
  10. Prat D., Gomel N., Zloto O., Anne M., BenSaid A., Bhattacharjee K., et. al. Low-dose bleomycin injections for orbital lymphatic and lymphatic-venous malformations: a multicentric case series study. Ophthalmic Plast Reconstr Surg. 2021; 01; 37(4): 361-5.
  11. Zamora A.K., Barry W.E., Nowicki D., Ourshalimian S., Navid F., Miller J.M., et. al. A multidisciplinary approach to management of abdominal lymphatic malformations. J Pediatr Surg. 2021; 56(8): 1425-9.
  12. Cho A.L., Kiang S.C., Lodenkamp J., Tritch W.T.H., Tomihama R.T. Fatal lung toxicity after intralesional bleomycin sclerotherapy of a vascular malformation. Cardiovasc Intervent Radiol. 2020; 43(4): 648-51.
  13. Карасева О.В., Тимофеева А.В., Горелик А.Л., Голиков Д.Е. Лапароскопические технологии в лечении кистозных лимфангиом брюшной полости у детей. Детская хирургия. 2021; 25(1, Прил.): 44.
  14. Шамсиев А.М., Шамсиев Ж.А., Давранов Б.Л., Муталибов И.А. Малоинвазивное хирургическое лечение врождённых лимфангиом у детей. Детская хирургия. 2021; 25(1, Прил.): 80.
  15. Shayesteh S., Salimian K.J., Fouladi D.F., Blanco A., Fishman E.K., Kawamoto S. Intra-abdominal lymphangioma: A case report. Radiol Case Rep. 2020; 16(1): 123-7.
  16. Cooke-Barber J., Dasgupta R. Management of visceral vascular anomalies. Semin Pediatr Surg. 2020; 29(5): 150977.
  17. Johnson A.B., Richter G.T. Surgical considerations in vascular malformations. Tech Vasc Interv Radiol. 2019; 22(4): 100635.
  18. Daigle H.J., Sakharuk I.A., Hatley R.M. Venolymphatic malformation: an uncommon pediatric inguinal mass. Am Surg. 2021; 87(1): 152-3.
  19. Merino Mateo L., Morante Valverde R., Redondo Sedano J.V., Benavent Gordo M.I., Gómez Fraile A. Mesenteric lymphatic malformation: a rare cause of an acute abdomen. An Pediatr (Barc). 2020; 92(1): 49-51.
  20. Пашкин К.П., Иванов А.Н., Иванова И.С. Лимфангиома брыжейки тонкой кишки как причина острого абдоминального синдрома у ребёнка 5 лет. Детская хирургия. 2020; 24(1): 50-2. https://dx.doi.org/10.18821/1560-9510-2020-24-1-50-52
  21. Сварич В.Г., Водолазский С.А., Перевозчиков Е.Г., Каганцов И.М., Сварич В.А. «Органосохраняющая операция при удалении лимфангиомы брюшной полости больших размеров у ребёнка трёх лет» Вятский медицинский вестник. 2020; 4(68): 102-5.
  22. Kulungowski A.M., Patel M. Lymphatic malformations. Semin Pediatr Surg. 2020; 29(5): 150971
  23. Поляев Ю.А., Петрушин А.В., Гарбузов Р.В. Интервенционные методы лечения лимфангиом у детей. Детская хирургия. 2011; (6): 41–3.

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