Bleomycin Electrosclerotherapy for Management of a Large Tongue Lymphovascular Malformation Causing Airway Obstruction

Abstract

Venous malformations are the most common congenital vascular anomaly. They are often symptomatic and are challenging to diagnose and treat. Bleomycin is an antineoplastic drug that has been used safely and effectively by intralesional administration in the treatment of vascular malformations. The use of reversible electroporation to increase cell membrane permeability to bleomycin has been utilized successfully in electrochemotherapy to significantly augment the cytotoxicity of bleomycin. We describe the use of bleomycin electroporation with sclerotherapy (bleomycin electrosclerotherapy) for treating a patient with a large low-flow lymphovascular malformation of the tongue causing intermittent airway obstruction. To the best of our knowledge, this is the first case report to describe the application of bleomycin electrosclerotherapy within the airway and to highlight the perioperative anesthetic challenges unique to this interventional approach.