Abstract:
Introduction. Cervical cystic lymphangioma is a malformation of the lymphatic vessels
predominantly located in the cervical, head or axillary area, but can affect any region. The location
of lymphangioma in the cervical area is of increased interest due to the involvement of vital
anatomical structures and the risk of obstructive syndrome. Since it is an infiltrative lesion
involving vessels and nerves, complete resection cannot always be achieved surgically and
requires alternative methods of treatment with a reduced risk of complications.
Aim of study. The aim of this study was to analyze the scientific material presenting the various
methods applied in the treatment of cervical cystic lymphangioma in children.
Methods and materials. Articles published in PubMed and Google Scholar between 2018-2023
were analyzed. Using the key words cervical lymphangioma and children we selected the most
relevant articles.
Results. The localization of cystic lymphangioma in the cervical area is most often manifested by
the presence of a mass which, reaching large sizes, can cause airway obstruction, dysphagia and
dysphonia. Treatment depends on the complexity of the lesion, the localization of the
lymphangioma, the level of involvement of vital structures, the age of the patient and the presence
of complications. The standard method is complete surgical resection in a single operation or
sometimes multiple surgeries are required for complete resection. In particular, surgery is chosen
if complications such as recurrent infection, bleeding in the cyst, airway compression, dysphagia
or accelerated growth occur. In some cases, however, involvement of major vessels and nerves
prevents complete resection, increasing the risk of recurrence of lymphangioma. Late
postoperative complications such as lymphorrhea, lymphoedema, hematoma, superinfection may
also occur. Currently there are various non-surgical methods of treatment such as sclerotherapy
(OK-432, bleomycin, monoclonal antibodies, doxycycline), simple drainage, corticosteroids,
radiotherapy, cryotherapy, laser excision, radiofrequency ablation, etc. New therapies include the
use of sildenafil, propranolol, sirolimus.
Conclusion. Surgical treatment remains the preferable method for cervical localization of cystic
lymphangioma as it allows complete removal and decreases the risk of recurrence. However, the
use of new treatment methods allows us to successfully manage complex cases of lymphangioma
with a reduced level of complications compared to surgery and is proposed by some specialists as
first line treatment.
