Microcystic lymphatic malformation (lymphangioma circumscriptum) treated using a minimally invasive technique of radiofrequency ablation and sclerotherapy.

Background: Therapeutic interventions for microcystic lymphatic malformation (MLM), including surgical resection, have historically been difficult and frustrating because of a high recurrence rate due to multifocal lesions and failure to address the deeper component and excessive morbidity associated with excision of extensive lesions.

Materials And Methods: This study represents a retrospective analysis of response to treatment of 14 consecutive patients with MLM. The first four patients were treated with sclerotherapy alone using 3% polidocanol. The next 10 patients were treated with the combination technique of radiofrequency ablation (RFA) and sclerotherapy. The sessions were repeated at monthly intervals until complete clearance.

Results: Nine of 10 patients who were treated with the combination technique achieved near-complete clearance. There were minimal intra- and postoperative sequelae. The patients treated with the combination technique also achieved faster results.

Conclusion: RFA ablates the lesions and achieves hemostasis while the sclerosant injected in and around the lesion reaches the deeper vascular lesions, preventing recurrence. The minimally invasive combination technique of RFA with sclerotherapy is a modality that can be used in the treatment of extensive microcystic malformations where surgical excision would lead to extensive scarring.