Sclerotherapy in Lymphatic Malformations with Intralesional Hemorrhage: A Retrospective Comparison with Non-Hemorrhagic Lymphatic Malformations

PURPOSE: To compare the outcomes of sclerotherapy with bleomycin and lauromacrogol between lymphatic malformations (LM) with and without intralesional hemorrhage and identify the factors affecting the outcomes of LM with hemorrhage. PATIENTS AND METHODS: This retrospective study examined patients with LM who underwent sclerotherapy with bleomycin and lauromacrogol between January 2019 and December 2021. Regression models were used to analyze the factors associated with the outcomes of LM with hemorrhage. RESULTS: 52 patients were included in the study, including 26 with intralesional hemorrhage. Masses with bluish skin (p = 0.026) and pain (p = 0.001) were more common in LM with hemorrhage. With similar outcomes, the average number of sessions was 2.9 in LM with hemorrhage and 2 in LM without hemorrhage (p = 0.028). The efficacies of the macrocystic and mixed types (93.3% and 83.3%, respectively) were higher than that of the microcystic type (40%) (p = 0.036). As the number of sessions increased, the relapse rate decreased (p = 0.018). CONCLUSION: Sclerotherapy with bleomycin and lauromacrogol is effective and safe for LM with hemorrhage. An increased number of injections for patients with hemorrhage was associated with similar efficacy for those without hemorrhage and similar relapse rates.