Surgical resection of macrocystic lymphatic malformations of the head and neck: Short and long-term outcomes

Bonilla‐Velez, Juliana; Moore, Brendan P.; Cleves, Mario A.; Buckmiller, Lisa M.; Richter, Gresham T.

doi:10.1016/j.ijporl.2020.110013

Cited by 20 publications

(13 citation statements)

References 47 publications

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“…While small or macrocystic lesions in general can be readily excised, lesions of larger size, diffuse and microcystic in nature, or involving surrounding structures such as nerves or blood vessels become very complicated and result in incomplete removal. In one case series of 63 patients, 14% had recurrence of macrocystic cervicofacial lymphatic malformation after excision, and associated factors for recurrence included bilaterality and advanced staging [ 72 ]. Cosmetic appearance, impaired functionality following excision, and scarring, in addition to other potential complications, including fistulization, infection, and dehiscence, need to be kept in mind.…”

Section: Discussionmentioning

confidence: 99%

Genetic and Molecular Determinants of Lymphatic Malformations: Potential Targets for Therapy

Lee

Loll

Hassan

et al. 2022

JDB

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Lymphatic malformations are fluid-filled congenital defects of lymphatic channels occurring in 1 in 6000 to 16,000 patients. There are various types, and they often exist in conjunction with other congenital anomalies and vascular malformations. Great strides have been made in understanding these malformations in recent years. This review summarize known molecular and embryological precursors for lymphangiogenesis. Gene mutations and dysregulations implicated in pathogenesis of lymphatic malformations are discussed. Finally, we touch on current and developing therapies with special attention on targeted biotherapeutics.

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Section: Discussionmentioning

confidence: 99%

Genetic and Molecular Determinants of Lymphatic Malformations: Potential Targets for Therapy

Lee

Loll

Hassan

et al. 2022

JDB

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“…As in many cases predictable, this should not be seen as a treatment complication. 87 The interdisciplinary team members should be aware that these seromas can be managed by endovascular treatment as well; thus, sclerotherapy through the surgical drains can be conducted if necessary.…”

Section: Interventional Treatment Optionsmentioning

confidence: 99%

Interventional Treatment Options in Children with Extracranial Vascular Malformations

et al. 2022

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Extracranial vascular malformations vary greatly and belong to the complex field of orphan diseases and can involve all segments of the vascular tree: arteries, capillaries, and veins, and similarly the lymphatic system. The classification according to the International Society for the Study of Vascular Anomalies (ISSVA) represents an important guidance for selecting appropriate therapy. Although many of the principles of endovascular treatment, including image-guided sclerotherapy and embolization, are similar in adult and pediatric practice, there are some distinct differences regarding the treatment of vascular malformations of children. Thus, it is crucial to involve longer-term plan about managing these chronic diseases and their impact on a growing child. This review provides a detailed overview over the clinical presentation of venous, lymphatic, and arteriovenous malformations in children and emphasizes the specifics of their interventional treatment options, including distinct pediatric dose limitations and procedure-related side effects.

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“…Long‐term recurrence‐free survival was achieved in 86% of patients. Of those patients who did ultimately require a second surgical intervention, 90% failed within 6 months of initial intervention 46 . Focal macrocystic lesions will more commonly displace local structures, whereas microcystic lesions tend to infiltrate soft tissue making complete resection unfeasible given the extent of soft tissue that would need to be removed.…”

Section: Managementmentioning

confidence: 99%

“…16 In performing surgery, complete resection is the only way to prevent regrowth; however, this is only possible in focal, macrocystic lesions. Bonilla-Velez et al 46 evaluated 63 patients who underwent excision of macrocystic LM. On long-term follow-up (median 12 months), treatment with a single surgical intervention resulted in complete response in 90.5% of patients.…”

Section: Managementmentioning

confidence: 99%

“…Of those patients who did ultimately require a second surgical intervention, 90% failed within 6 months of initial intervention. 46 Focal macrocystic lesions will more commonly displace local structures, whereas microcystic lesions tend to infiltrate soft tissue making complete resection unfeasible given the extent of soft tissue that would need to be removed. When complete resection is not possible, great care should be taken during excision to protect vital structures and not limit function.…”

Section: Managementmentioning

confidence: 99%

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Multimodality treatment of vascular anomalies of the head and neck

Dorrity

Mack

Wong

et al. 2022

J Oral Pathology Medicine

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Background: Vascular anomalies affect up to 5% of children with the majority affecting the head and neck. They present at different ages as a wide variety of lesions. A careful evaluation with history, physical examination, and imaging assists in the proper diagnosis. Depending upon the condition treatment options for vascular anomalies include topical therapy, selective photothermolysis, sclerotherapy, embolization, surgical excision, and targeted systemic therapy. Conclusion:Staged multimodal therapeutic regimens have proven to best control disease and allow for the preservation of function and aesthetics. The timing, sequence, and combination of therapies are best determined by a multidisciplinary vascular anomalies team. Patients and families need to be counseled on anticipated positive outcomes following a protracted course of treatment for the majority of vascular anomalies.

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Surgical resection of macrocystic lymphatic malformations of the head and neck: Short and long-term outcomes

Cited by 20 publications

References 47 publications

Genetic and Molecular Determinants of Lymphatic Malformations: Potential Targets for Therapy

Genetic and Molecular Determinants of Lymphatic Malformations: Potential Targets for Therapy

Interventional Treatment Options in Children with Extracranial Vascular Malformations

Multimodality treatment of vascular anomalies of the head and neck

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