Video assisted sclerosis of endoabdominal lymphangiomas with OK432: An effective, safe and minimally invasive choice

Abstract Lymphatic malformations (LM) or lymphangiomas are congenital errors in vascular embryogenesis. Percutaneous sclerosis is considered the best treatment for LM with external localization and yields excellent results. Surgical resection for deep LM is currently the mainstay of therapy, but high recurrence and morbidity rates are reported. Uniform therapeutic protocols are still unavailable. We describe two cases of abdominal LM treated by video-assisted sclerosis with OK432. The first case was a 5-month-old girl with pre-natal diagnosis of a left retroperitoneal LM with vascular encasement. A laparoscopic approach was used to expose the mass and a video-assisted injection of OK-432 in major cysts was performed. A remarkable reduction of the lesion size was observed after 18 months. The second case was a 15-year-old boy who presented at the ER acute abdominal pain. A mesenteric LM was diagnosed and a video-assisted sclerosis of the lesion with OK432 was performed. The LM completely disappeared. Follow-up was of 12 months. In our experience, video-assisted sclerosis of abdominal LM with OK-432 is a valid alternative to surgical resection. The procedure is feasible, safe, effective and minimally invasive; complete resolution may be observed in some cases. Long-term follow-up is required to rule out recurrences.