Thirty-eight children with lymphangioma were treated at the second Department of Surgery, Kyoto University Hospital, from May 1976 to March 1983. In only 5 out of 13 cases, a complete excision of the lesion was carried out. Bleomycin (BLM) was injected into the cavity of lymphangioma in 34 patients primarily or after surgical treatment. In 33 cases, BLM was used in a form of sphere-in-oil emulsion developed by Hashida in 1976. Injection of 0.6 mg BLM emulsion per kg body weight was repeated at intervals of 4 to 6 weeks. In 27 cases (81%) lymphangioma regressed and in 13 cases (39%) it almost disappeared. Cystic hygroma was particularly sensitive to this therapy. In responding cases, the total injected dose was 0.6 to 4 mg/kg body weight. BLM emulsion was not effective in 6 cavernous lymphangiomas in extremities (4) and in the chest wall (2). Fever was the most common side effect (53%). Pulmonary fibrosis was not observed. The most serious complication was dyspnea which was seen in a 7 month old girl due to transient swelling of cervicomediastinal lymphangioma after BLM emulsion injection. There was no re-growing of the residual induration after BLM emulsion therapy.
