Mixed capillary/lymphatic malformation with coexisting port-wine stain: Treatment utilizing 3D MRI and CT-guided sclerotherapy

BACKGROUND. Lymphatic malformation, a benign malformation of the skin and t he subcutaneous tissues, is divided into two major groups: the classical an d the localized forms. Pathologically lymphatic malformation often consists of sequestered lymphatic cisterns with thick muscle walls lying deeply in the subcutaneous tissue. Communicating via dermal lymphatic channels with s uperficial pseudovesicles, they can vary in size depending on the pressure transmitted by the cisterns beneath. METHODS. We present a patient with mixed capillary/lymphatic malformation a nd coexisting port-wine stain since birth. To demonstrate the anatomic exte nt and the subcutaneous involvement we performed a 3D reconstruction of a m agnetic resonance imaging (MRI). The diagnostic procedures, therapeutic pos sibilities, and complications regarding this rare appearance are reviewed. RESULTS. Good results could be obtained with CO2 laser vaporization of the superficial lesions and computed tomography (CT)-guided transcutaneous scle rotherapy for the deeper cisterns with doxycycline. CONCLUSION. The combination of CO2 laser treatment and sclerotherapy with d oxycycline seems to present a treatment option for cutaneous and subcutaneo us lymphangioma circumscriptum with rare side effects.