Treatment of Cystic Hygroma in Children with Special Reference to OK-432 Therapy

Abstract

During a five-year period, 18 patients with cystic hygroma were treated as follows: 8 patients were treated surgically, 3 patients were treated by sclerosing therapy with Bleomycin (BLM) and 9 patients including 2 secondary to incomplete surgical therapy were treated by sclerosing therapy with OK-432 (Picibanil; Chugai Pharmaceutical Co. Ltd., Tokyo). OK-432 therapy for cystic hygroma showed excellent results; cure was noted in 8 patients, and marked regression with the expectation of subsequent cure was noted in the other patient. Complete excision of the cystic hygromas was possible in 4 patients and resulted in cure; but only partial excisions could be performed in the other 4 patients because of the surrounding tissue and the results were unfavorable. BLM therapy gave insufficient results and was not considered a favorable treatment.

Sudden Onset, Rapidly Expansile, Cervical Cystic Hygroma in an Adult: A Rare Case with Unusual Presentation and Extensive Review of the Literature

“…OK-432 (picibanil) is obtained from a lyophilized mixture of Group A pyogenes streptococcus and because of immunomodulating effect it increases several cytokines, such as interleukin- (IL-) 1, IL-2, interferon gamma, IL-6, and tumour necrosis factor, thus increasing endothelial permeability, accelerating lymphatic drainage, and fostering retraction of cystic cavity [62, 63]. Yura et al [64] and Ogita et al [65] first reported use of intralesional bleomycin and OK-432 with excellent results. Complete resolution was noted in eight out of nine patients treated with intralesional injection of OK-432 by Ogita et al Sainsbury et al [66] observed 100% overall response rate and 40% complete response rate in patients treated with intralesional bleomycin.…”

Abdominal lymphangiomas in children: interest of the laparoscopic approach

“…Until now, lack of control has caused this intraabdominal injection to be avoided (1 case reported [13]). …”

Endovascular Management of Head and Neck Vascular Malformations

“…Originally conceived as an immunotherapeutic agent in the treatment of gastric and lung carcinoma, it was used as an experimental sclerosant in the treatment of an LM in 1987 [39]. The protocol for OK-432 is injection of 0.01 mg/mL dilution of OK-432 in physiological serum for the desired volume [39,40]. The therapeutic response of OK-432 is delayed, typically taking about 6 weeks or more.…”