1249 www.eymj.org INTRODUCTION Lymphatic malformations are benign congenital malforma- tions of lymphatic vessels and channels that are caused by the failure of lymph spaces to connect to the rest of the lymphatic system. Tey are lined by endothelial cells and separated by a scant intervening connective tissue stroma that often contains lymphoid aggregates. 1 Classical treatment is surgical excision. However, complications such as damage to the nervous and vascular structures, incomplete excision, fistula formation, wound infection, or wound dehiscence may occur. Tus, sclero- therapy using ethanol, bleomycin, doxycycline, or OK-432 was the preferred treatment of macrocystic lymphatic malforma- tion. Currently, the two most extensively investigated scleros- ing agents are bleomycin and OK-432. 2-4 We present herein a case of a patient with cervical lymphatic malformation who was cured with sclerotherapy using povi- done-iodine. To our best knowledge, this is the frst report of the use of povidone-iodine sclerotherapy for cervical lymphatic malformation. CASE REPORT A 24-year-old woman with a 1-week history of neck swelling visited our outpatient clinic. Te patient had no signifcant me- dical or family history. On physical examination, the patient was found to have a soft, smooth, non-tender mass at the right posterior neck area. Computed tomography revealed a fuid- filled cyst in the right posterior fossa, extending to the right omohyoid muscle, compatible with lymphatic malformation. Te cyst was 5.5×3.8×5.4 cm in size and had a heterogeneous density, suggesting blood in the cyst (Fig. 1). Ultrasonography- guided percutaneous drainage and sclerotherapy were per- formed because the size of the cyst did not change after 2 months of observation. Daily povidone-iodine sclerotherapy was per- formed for 3 days. Before the procedure, authors checked the patient’s history of allergic reaction to povidone-iodine. Be- cause povidone-iodine is one of the easily obtainable antisep- tics, the patient had the experience of povidone-iodine usage and denied allergic reaction. In the supine position, the patient underwent percutaneous puncture of the cystic lymphatic mal- formation and drainage of fuid content with an 8.5 F pigtail ca- theter (Cook, Bloomington, IN, USA). After aspiration of clear and yellow fuid (70 mL), a mixture of 0.5% lidocaine (10 mL), contrast medium (15 mL), and normal saline (15 mL) was in- Received: August 29, 2016 Revised: November 9, 2016 Accepted: November 24, 2016 Corresponding author: Dr. Chan Il Song, Department of Otorhinolaryngology- Head and Neck Surgery, Jeju National University School of Medicine, 102 Jejudae- hak-ro, Jeju 63243, Korea. Tel: 82-64-717-2108, Fax: 82-64-717-1097, E-mail: songchanil@gmail.com •The authors have no financial conflicts of interest. © Copyright: Yonsei University College of Medicine 2017 This is an Open Access article distributed under the terms of the Creative Com- mons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/4.0) which permits unrestricted non-commercial use, distribution, and repro- duction in any medium, provided the original work is properly cited. Percutaneous Drainage and Povidone-Iodine Sclerotherapy of Cervical Lymphatic Malformation Seung Hyoung Kim 1 , Mu Sook Lee 1 , Gil Chai Lim 2 , and Chan Il Song 2 Departments of 1 Radiology and 2 Otorhinolaryngology-Head and Neck Surgery, Jeju National University School of Medicine, Jeju, Korea. Lymphatic malformations in cases with macrocystic lesions can be treated with surgical excision or sclerotherapy using alcohol, bleomycin, doxycycline, or OK-432. We report a case of a 24-year-old woman who underwent percutaneous drainage and povi- done-iodine sclerotherapy as primary treatment for cervical lymphatic malformation. Te patient underwent povidone-iodine sclerotherapy for 3 consecutive days. After 8 months, ultrasonography of the lesion in the neck revealed complete resolution of the cervical lymphatic malformation without any complication. Povidone-iodine sclerotherapy can be a safe and cost-efective treatment option for cervical lymphatic malformation. Key Words: Lymphatic malformation, povidone-iodine, sclerotherapy Case Report pISSN: 0513-5796 · eISSN: 1976-2437 Yonsei Med J 2017 Nov;58(6):1249-1251 https://doi.org/10.3349/ymj.2017.58.6.1249