A Case Report on Cystic Hygroma of Arm Treated with OK-432

Abstract

The present study reports a case of a newborn baby with Down’s syndrome presented with cystic hygroma in his left arm and forearm. Cystic hygromas are the cystic variety of lymphangioma, common locations being cervico-facial regions and axilla. Respiratory distress, recurrent infections or cosmetic reasons are the main indications of the treatment.  A newborn male neonate with features of Down’s syndrome presented to the special care nursery (SCN) of our institution with complaint of swelling of left arm and left forearm on day-1 of life. The edema in the baby's left arm was treated with OK-432. However, at the age of five months, the patient had severe sepsis as a result of gangrene in his left arm and associated meningitis, resulting in his death.

Picibanil, also known as OK-432, has been used to treat cystic hygroma with great effectiveness for the past two decades. Although cystic hygroma has been associated with a nuchal lymphangioma, Turner’s syndrome, and Noonan syndrome, there is evidence that cystic hygroma occurs more frequently in Down’s syndrome. More case controlled studies should be conducted in the future to better understand the adverse effects of sclerosant therapy, which has the potential to be an optimal treatment for cystic hygroma.