Efficacy of Intralesional Bleomycin Sclerotherapy in Children Presenting with Cystic Hygroma

Sadazeb Mian; Muhammad Imran; Zia Ullah Bacha; . Irfan

doi:10.54112/bcsrj.v7i5.2306

Authors

Sadazeb Mian Department of Paediatric Surgery, Khyber Teaching Hospital Peshawar, Pakistan
Muhammad Imran Department of Paediatric Surgery, Khyber Teaching Hospital Peshawar, Pakistan
Zia Ullah Bacha Department of Paediatric Surgery, Khyber Teaching Hospital Peshawar, Pakistan
. Irfan Department of Paediatric Surgery, Khyber Teaching Hospital Peshawar, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v7i5.2306

Keywords:

Breastfeeding Paediatrics, Bleomycin Sclerotherapy, Intralesional, Efficacy, Cystic Hygroma

Abstract

Cystic hygroma is a congenital lymphatic malformation commonly affecting children, particularly in the cervical region. Surgical excision has traditionally been the standard treatment; however, it may be associated with recurrence and surgical complications. Intralesional bleomycin sclerotherapy has emerged as a minimally invasive alternative with promising therapeutic outcomes and a favorable safety profile. Objective: To determine the efficacy of intralesional bleomycin sclerotherapy in children presenting with cystic hygroma. Methods: This descriptive case series study was conducted on 68 children aged 3–15 years diagnosed with cystic hygroma from 06-01-2025 to 06-04-2025. Patients with abdominal lymphangiomas, a history of recent surgery, or arteriovenous malformations were excluded. All participants underwent intralesional bleomycin sclerotherapy. Treatment efficacy was assessed at a two-month follow-up and categorized as complete response, good response, or poor response based on clinical regression of the lesion. Adverse effects associated with treatment were also recorded. Data were analyzed using SPSS version 25. Descriptive statistics were used to summarize demographic characteristics, lesion distribution, treatment response, and adverse events. Results: The mean age of the patients was 8.96 ± 3.53 years. There were 39 (57.4%) males and 29 (42.6%) females. The most common site of involvement was the neck, observed in 40 (58.8%) patients, followed by the axilla in 19 (27.9%) patients. Complete response was achieved in 35 (51.5%) patients, while 20 (29.4%) demonstrated a good response and 13 (19.1%) showed a poor response. Overall, favorable outcomes (complete or good response) were observed in 55 (80.9%) patients. Regarding safety, 59 (86.8%) patients experienced no adverse effects following treatment. Conclusion: Intralesional bleomycin sclerotherapy is an effective and safe treatment modality for cystic hygroma in children, achieving complete resolution in more than half of the patients and favorable outcomes in over 80% of cases. Its low rate of adverse effects supports its use as a minimally invasive alternative to surgical management.

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