Abstract No. 584 Percutaneous Sclerotherapy of Lymphatic Malformations: Outcomes at a Tertiary Care Pediatric Center

Percutaneous sclerotherapy (PS) is a safe and less invasive approach to treat lymphatic malformations (LM). The purpose of this institutional review board–approved retrospective review was to characterize LM and evaluate outcomes with PS at a tertiary care pediatric center. Twenty-five children (11 boys, 14 girls) underwent PS for LM at our institution from 2015-2023. Demographics, imaging, treatments, outcomes, and follow-up were obtained. Lesion size was defined by the maximal cross-sectional area (cm2). Change in lesion size was measured pre- and post-procedure. The mean age at first treatment was 5.4 years (range, 0-18 years). The most frequent anatomic location treated was cervicofacial (n=13, 52.0%) followed by truncal (n=6, 24.0%), and extremity (n=6, 24.0%). There were 19 (76.0%) macrocystic (macro) LM (median lesion size 14 cm2, range 2.4 - 45.4 cm2) and 6 (24.0%) "mixed" macro-/microcystic LM (median lesion size 3.1 cm2, range 1.8 - 14.7 cm2). Sclerosing agents used included doxycycline (D) (n=14, 56.0%), combined doxycycline and bleomycin (D + B) (n=7, 28.0%), and combined doxycycline and ethanol (D + E) (n=3, 12.0%). Median lesion size change (cm2) for these groups is reported in Table 584.1. Comparisons did not reach significance. One (4.0%) patient had unsuccessful treatment. Two (8.0%) patients were lost to follow-up before clinical response could be measured. Fifteen (60.0%) patients required retreatment, including 7 (28.0%) for residual disease, 6 (24.0%) for intralesional bleeding, and 2 (8.0%) for persistent pain. Median follow-up time was 10.7 months (range, 2.0-97.2 months). PS with D + B showed the highest response in macro-LM and PS with doxycycline alone showed highest response in mixed LM; however, small sample size limited reaching significance. Further study is needed for more robust comparison between different sclerosing agents and lesion type.