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Late side effects of bleomycin injection into the lower lip mucosa of a nine-year-old patient with venous malformation

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Venous malformation (VM) is a benign lesion of blood vessels caused by an error in vascular morphogenesis during the embryologic phase. This entity mostly affects the head and neck region, including the lips, tongue, buccal mucosa, gingiva, or palate. VM may cause functional and aesthetic impairments. The anatomical structure and shape of the lips provide an important aesthetic accent for an individual. Therefore, management of VM in the lip area without postoperative defects or scarring is challenging. In this brief communication article, we present a conservative approach to lip VM in a nine-year-old boy using a bleomycin injection that had good aesthetic and functional outcomes. Injection of 2 mL of 1/10 of 15 mg bleomycin in a saline dilution into the lip mucosa may present a drug reaction as a white plaque and reddish owl eye lesion that takes up to three weeks to resolve without a scar. It is important to recognize the characteristics and self-limiting nature of postoperative bleomycin complications to avoid unnecessary treatment.

Abstract

Venous malformation (VM) is a benign lesion of blood vessels caused by an error in vascular morphogenesis during the embryologic phase. This entity mostly affects the head and neck region, including the lips, tongue, buccal mucosa, gingiva, or palate. VM may cause functional and aesthetic impairments. The anatomical structure and shape of the lips provide an important aesthetic accent for an individual. Therefore, management of VM in the lip area without postoperative defects or scarring is challenging. In this brief communication article, we present a conservative approach to lip VM in a nine-year-old boy using a bleomycin injection that had good aesthetic and functional outcomes. Injection of 2 mL of 1/10 of 15 mg bleomycin in a saline dilution into the lip mucosa may present a drug reaction as a white plaque and reddish owl eye lesion that takes up to three weeks to resolve without a scar. It is important to recognize the characteristics and self-limiting nature of postoperative bleomycin complications to avoid unnecessary treatment.

참고문헌 (6)

  1. Couto DAF, "Sclerotherapy for extensive vascular malformation in the tongue", J Craniofac Surg, 30, pp.e796~e799 (2019)[DOI]
  2. Zeevi I, "Sclerotherapy of vascular malformations in the oral cavity-minimizing postoperative morbidity", Medicina(Kaunas), 56, pp.254~ (2020)[DOI]
  3. Bajpai H, "Comparative analysis of intralesional sclerotherapy with sodium tetradecyl sulfate versus bleomycin in the management of low flow craniofacial soft tissue vascular lesions", J Maxillofac Oral Surg, 11, pp.13~20 (2012)[DOI]
  4. Hong-Gi Min, "Sclerotherapy using 1% sodium tetradecyl sulfate to treat a vascular malformation: a report of two cases", 대한구강악안면외과학회지, 41(6), pp.322~326 (2015), 대한구강악안면외과학회
  5. Berenguer B, "Sclerotherapy of craniofacial venous malformations : complications and results", Plast Reconstr Surg, 104, pp.1~11 (1999)
  6. Song D, "DSA-guided percutaneous sclerotherapy for children with oropharyngeal lowflow venous malformation", Exp Ther Med, 19, pp.3405~3410 (2020)[DOI]

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