Duration 5min, Q&A 3min
Intralesional Bleomycin As a Treatment Modality for Orbital Lymphangiomas, Eyelid Basal Cell Carcinomas and Resistant Capillary Hemangiomas
A case series of extensive capillary hemangiomas¸ orbital lymphangiomas and eyelid basal cell carcinomas are presented where the response to conventional therapy was inadequate and the subsequent response to intralesional bleomycin injections was positive.
Patients were recruited from the Oculoplastics Clinic at Tygerberg Academic Hospital¸ Cape Town¸ South Africa. In all cases conventional therapies for the different conditions either failed or surgery was refused or contraindicated. All patients were offered intra lesional bleomycin as alternate therapy with varying inter individual injection durations determined by tumor response.
Pre and post operative photographs were taken and consent was obtained. Pre operative local anaesthesia¸ general or conscious sedation was used depending on the age and patient´s needs. A solution containing 1 international unit bleomycin per ml saline together with 2 percent lignocaine was injected intralesionally via a multipuncture technique. The injected volume was calculated to be equivalent to the volume of the lesion. Retreatment was performed on a 48 weekly basis until satisfactory clinical endpoints were achieved.
Results and Conclusion
Intra lesional bleomycin induced significant regression with marked clinical improvement and reduction in tumor size of capillary hemangiomas¸ orbital lymphangiomas and eyelid and orbital BCC´s obviating the need for further surgical intervention in most cases. Based on our experience with the drug we propose that intra lesional bleomycin could be considered as treatment modality in cases where conventional intervention is not possible. Intra lesional bleomycin has a favourable side effect profile making it an important management consideration in such cases.
[ Keyword ]
bleomycin / lymphangiomas / basal cell carcinoma
[ Conflict of Interest ]