Endoscopic injection sclerotherapy with doxycycline for mediastinal and esophageal lymphangiohemangioma

BackgroundLymphangiohemangioma, also called lymphatic-venous or venolymphatic malformation, is a rare malformation of the lymphatics, with vascular elements. These are low-flow vascular lesions.ObjectiveTo evaluate the feasibility and efficacy of endoscopic injection sclerotherapy with doxycycline for low-flow vascular malformations in the GI tract.DesignCase report.SettingAcademic center.PatientsAn adult man with lymphangiohemangioma that involved the mediastinum and the esophagus. The esophageal involvement caused dysphagia and chest pain.InterventionsWe characterized the lesion with EUS and successfully treated the esophageal and paraesophageal lesions with endoscopic injection sclerotherapy by using doxycycline.Main Outcome MeasurementSymptom resolution and complications.ResultsThe patient's esophageal symptoms resolved with sclerotherapy. This is the first reported case of lymphangiohemangioma with esophageal involvement and the first reported case of endoscopic injection sclerotherapy by using doxycycline in the GI tract.LimitationsCase report and short follow-up period.ConclusionsEndoscopic injection sclerotherapy with doxycycline for lymphatic and low-flow vascular malformations in the GI tract is feasible, easy, safe, and effective.