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Bleomycin sclerotherapy for severe symptomatic and persistent pelvic lymphocele.

Fernandes AS, Costa A, Mota R, Paiva V - Case Rep Obstet Gynecol (2014)

Bottom Line: A 72-year-old woman presented with severe symptomatic and refractory lymphocele associated with persistent lower limb lymphedema and recurrent erysipelas.Conclusion.Bleomycin is a safe and effective sclerosing agent and therefore should be regarded as a first-line treatment choice.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynaecology, São João Hospital Center, Portugal.

ABSTRACT
Background. Pelvic lymphoceles are frequently described as a complication of pelvic lymphadenectomy performed for surgical staging of gynaecologic malignancies. Case Report. A 72-year-old woman presented with severe symptomatic and refractory lymphocele associated with persistent lower limb lymphedema and recurrent erysipelas. After four CT fluoroscopy scan guided percutaneous catheter drainages, the lymphocele complicated with infection finally resolved with two sessions of bleomycin sclerotherapy. Conclusion. Symptomatic persistent lymphoceles require treatment and nowadays the first option is interventional radiologic procedures. Bleomycin is a safe and effective sclerosing agent and therefore should be regarded as a first-line treatment choice.

No MeSH data available.


Related in: MedlinePlus

Pelvic lymphocele recurrence.
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Related In: Results  -  Collection


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fig1: Pelvic lymphocele recurrence.

Mentions: After six days of unsuccessful empirical antibiotherapy with flucloxacillin for the erysipelas, she was readmitted. A CT fluoroscopy scan guided percutaneous catheter drainage was performed. Externalization of a clear, slightly yellow-tinged, benign, and sterile fluid was achieved with trocar technique with a 7F Huisman catheter. There was a progressive improvement of the lymphedema and erysipelas, and the drain was removed six days after (last day output 200 mL/24 h with previous medium output/24 h of 850 mL), with ultrasound confirmation of left lymphocele shrinkage with 51∗40 mm; however, six days later she complained of excruciating left inguinal and lower left sided back pain. Imagiologic evaluation by ultrasound and CT pelvic scan revealed recurrence of left lymphocele with 106∗54 mm, impairing venous drainage of the inferior limb (Figure 1). Fifteen days after the first drainage, another CT fluoroscopy scan guided percutaneous complete drainage was performed (200 mL), using Seldinger technique with an 8F pigtail catheter, and was removed four days later (last day output 150 mL/24 h with previous medium output/24 h of 550 mL). Twenty-two days after the admission she was discharged with no pain and lymphedema improvement.


Bleomycin sclerotherapy for severe symptomatic and persistent pelvic lymphocele.

Fernandes AS, Costa A, Mota R, Paiva V - Case Rep Obstet Gynecol (2014)

Pelvic lymphocele recurrence.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4109129&req=5

fig1: Pelvic lymphocele recurrence.
Mentions: After six days of unsuccessful empirical antibiotherapy with flucloxacillin for the erysipelas, she was readmitted. A CT fluoroscopy scan guided percutaneous catheter drainage was performed. Externalization of a clear, slightly yellow-tinged, benign, and sterile fluid was achieved with trocar technique with a 7F Huisman catheter. There was a progressive improvement of the lymphedema and erysipelas, and the drain was removed six days after (last day output 200 mL/24 h with previous medium output/24 h of 850 mL), with ultrasound confirmation of left lymphocele shrinkage with 51∗40 mm; however, six days later she complained of excruciating left inguinal and lower left sided back pain. Imagiologic evaluation by ultrasound and CT pelvic scan revealed recurrence of left lymphocele with 106∗54 mm, impairing venous drainage of the inferior limb (Figure 1). Fifteen days after the first drainage, another CT fluoroscopy scan guided percutaneous complete drainage was performed (200 mL), using Seldinger technique with an 8F pigtail catheter, and was removed four days later (last day output 150 mL/24 h with previous medium output/24 h of 550 mL). Twenty-two days after the admission she was discharged with no pain and lymphedema improvement.

Bottom Line: A 72-year-old woman presented with severe symptomatic and refractory lymphocele associated with persistent lower limb lymphedema and recurrent erysipelas.Conclusion.Bleomycin is a safe and effective sclerosing agent and therefore should be regarded as a first-line treatment choice.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynaecology, São João Hospital Center, Portugal.

ABSTRACT
Background. Pelvic lymphoceles are frequently described as a complication of pelvic lymphadenectomy performed for surgical staging of gynaecologic malignancies. Case Report. A 72-year-old woman presented with severe symptomatic and refractory lymphocele associated with persistent lower limb lymphedema and recurrent erysipelas. After four CT fluoroscopy scan guided percutaneous catheter drainages, the lymphocele complicated with infection finally resolved with two sessions of bleomycin sclerotherapy. Conclusion. Symptomatic persistent lymphoceles require treatment and nowadays the first option is interventional radiologic procedures. Bleomycin is a safe and effective sclerosing agent and therefore should be regarded as a first-line treatment choice.

No MeSH data available.


Related in: MedlinePlus