Percutaneous sclerotherapy of lymphangiomas with acetic acid

PURPOSE: To evaluate the efficacy of percutaneous image-guided sclerotherapy of lymphangiomas with use of acetic acid. MATERIALS AND METHODS: Twelve patients with lymphangiornas were treated with acetic acid as the sclerosant. There were eight male patients and four female patients, ranging in age from 1 to 29 years (mean, 11 years). The lymphangiomas were located at the neck (n = 5), upper extremity (n = 3), axilla (n = 1), cervicomediastinum (n = 1), anterior chest wall (n = 1), and retroperitoneum (n = 1). Two patients had recurrent lymphangiomas after surgery and two patients had undergone failed sclerotherapy with another sclerosant. The acetic acid used as the sclerosant was 40%-50% in concentration, and the amounts used ranged from 2 mL to 70 mL (mean, 11.3 mL), which was equivalent to 4.6%-50% (mean, 30.6%) of the aspirated lymphatics. All procedures were performed under ultrasonographic and fluoroscopic guidance. The sclerosant was removed after sclerotherapy. All patients except one underwent one treatment session. RESULTS: Complete resolution of the lymphangioma was achieved in eight patients (66.7%), good resolution (> 50% reduction) was achieved in three (25.0%), and poor resolution (< 50% reduction) was seen in one (8.3%). Complications encountered included pneumonitis adjacent to the lymphangioma (n = 1), pain (n = 2), hematuria (n = 1), and tingling sensation in the forearm (n = 1). CONCLUSION: Percutaneous sclerotherapy of the lymphangiomas with use of acetic acid is an effective method without serious complications.