Cystic hygroma is recognized in infants and children as a benign tumor of the neck. Local injection of OK-432 for cystic hygroma is commonly performed as the therapy of first choice. However, although OK-432 therapy showed remarkable effectiveness, differentiation between cystic hygroma and hemangioma was quite important for a good outcome. A 1-year-old-girl, whose CT and MRI showed large multilobular cystic tumor of the lateral neck expanding to the contralateral side, was diagnosed as cystic hygroma and treated with intralesional injection of OK-432. In this case, the hygroma decreased remarkably. A 3-year-old-girl, whose Tl MRI showed an isointense and partially hypointense tumor of the lateral neck, was diagnosed as a cystic hygroma with a hemangioma and treated with intralesional injection of OK-432. In this case, the hygroma decreased considerably, but the hemangioma persisted. In these cases, MRI and CT could not accurately differentiate cystic hygroma from hemangioma, but ultrasonography and biopsy provided useful information for reliable diagnosis and treatment.
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