Treatment of lymphangiomas in children: An update of Picibanil (OK-432) sclerotherapy
Otolaryngology - Head and Neck Surgery
Picibanil (OK-432) is a sclerosing agent derived from a low-virulence strain of Streptococcus pyogenes that induces regression of macrocystic lymphangiomas. This report describes a prospective, nonrandomized trial to evaluate the efficacy of Picibanil in the treatment of 13 affected children ranging in age from 1 to 94 months. On average, 4.1 fluoroscopically guided intracystic injections were performed per child, with an average total dose of 0.56 mg of Picibanil. As judged by physical examination and radiographic studies, 5 children (42%) showed a complete or substantial response, and 2 children (16%) showed an intermediate response. No response was seen in 5 children (42%), 2 of whom had massive craniofacial lymphangioma. Factors that contribute to failure with Picibanil sclerotherapy are the presence of a significant microcystic component to the lesion, massive craniofacial involvement, and previous surgical resection. Macrocystic lymphangiomas of the infratemporal fossa or cervical area have the best response to therapy.
Greinwald, J., Burke, D., Sato, Y., Poust, R., Kimura, K., Bauman, N., & Smith, R. (1999). Treatment of lymphangiomas in children: An update of Picibanil (OK-432) sclerotherapy. Otolaryngology - Head and Neck Surgery, 121 (4). http://dx.doi.org/10.1016/S0194-5998(99)70225-1