Successful treatment of vaginal and pelvic microcystic lymphatic malformations by 50% ethanol injection via lymph node angiography

Abstract Clinically, surgical treatment and sclerotherapy are the main treatments for lymphatic malformation (LM), but the diagnosis and treatment of microcystic LM has numerous pitfalls. Microcystic LM within the vagina and pelvis is not easily visible, and there are many side effects of treatment. Lymphangiography, a relatively old method of identifying diseases of the lymphatic system, has been rarely used in clinical settings due to the difficulty of performing this test. In this article, we use a special lesion site adjacent to the nearby lymph nodes for the treatment of vagina and pelvic microcystic LM. Lymphangiography is performed through lymph node aspiration combined with direct local puncture of the lesion, guided by the injection of iodine oil, which can exhibit a better outcome and more complete removal of the lesion. Finally, sclerotherapy is conducted using a low concentration of 50% ethanol with good fluidity, which covers the lesion to a great extent. This methodology was shown to be effective in treating children with vaginal and pelvic microcystic LM. This article reports the first case of treating children with vaginal and pelvic microcystic LM using lymph node lymphangiography combined with local puncture angiography, providing a new method of diagnosing and treating children with microcystic LM.