Pediatric lymphangiomas of the head and neck

To better define the cause, presentation, diagnosis, and staging of lymphangiomas, we reviewed all cases of lymphangiomas of the head and neck region in children seen at our institution between 1986 and 1996. Sixty-seven children were identified (31 male and 36 female). Age at presentation ranged from birth to 18 years. All but 8 patients presented with an obvious mass, and 5 required tracheotomy because of airway obstruction. The most common location was the submandibular region (37%), followed by the parotid gland (31%). Treatment ranged from observation to extensive and multiple resections. Thirty-one patients underwent only 1 resection, and 2 patients received interferon as part of their treatment. Lesions involving the lip, hypopharynx and/or larynx, the tongue, and the floor of the mouth had high rates of recurrent or persistent disease. We review our experience with these difficult lesions and propose a staging system based on functional deficit, cosmetic changes, sites of involvement, and age at diagnosis.