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Lymphatic Malformations

Home » Conditions » Vascular Malformations » Lymphatic Malformations

Lymphatic malformations are rare vascular anomalies that can cause firm, non-compressible masses, skin vesicles, mucosal blisters, swelling, and recurrent infections. Led by Dr. Waner and Dr. O, the Vascular Birthmark Institute specializes in diagnosing and treating these complex conditions, offering expert care to improve your comfort, function, and quality of life.

What Are Lymphatic Malformations?

Lymphatic malformations are abnormalities of the lymphatic system caused by defective vessels that collect fluid and form masses. These lesions can vary in size and severity and may be made up of large cysts (macrocystic) or small cysts (microcystic). Over time, they typically enlarge, sometimes rapidly during infections, hormonal changes, or trauma. Lymphatic malformations often present as firm, non-compressible masses and may cause fluid-filled vesicles on the skin or mucosa. Without treatment, they can lead to significant discomfort, swelling, and functional impairment as they progressively expand.

Signs & Symptoms of Lymphatic Malformations:

Firm, non-compressible masses under the skin
Fluid-filled vesicles on the skin or mucosal surfaces
Swelling that may worsen with infections, trauma, or hormonal changes
Leakage of blood-tinged lymph from ruptured vesicles
Pain, discomfort, or burning sensations, especially with acidic or spicy foods
Enlargement of the affected area over time
Difficulty eating or speaking when the tongue or mouth is involved
Recurrent infections in the affected area

Treatments for Lymphatic Malformations

When you visit the Vascular Birthmark Institute, your treatment plan for lymphatic malformations is customized based on the type, size, and location of your lesion. We will perform a thorough evaluation, including imaging studies such as ultrasound, MRI, or CT scans, to understand whether your lesion is macrocystic, microcystic, or both. After diagnosis, we curate a personalized plan that may involve one or several therapies aimed at reducing the size of the malformation, relieving symptoms, and improving your quality of life.

Laser Treatment

If you have fluid-filled blisters (vesicles) on your skin or in your mouth, laser treatment can help. We use a CO₂ laser to remove these vesicles. The laser energy vaporizes the surface lesions without damaging the surrounding healthy tissue. This helps stop the leakage of blood-tinged lymph, reduces discomfort from eating acidic foods, and improves the appearance of the mucosa. Although laser treatment may not cure the underlying malformation, it enhances your comfort and quality of life. Treatments are done under general anesthesia.

Sclerotherapy

Sclerotherapy can effectively shrink lymphatic malformations, particularly those with large cysts or tongue involvement. During this minimally invasive procedure, a sclerosing agent—such as bleomycin, OK-432, or doxycycline—is injected into the lymphatic tissue. The medication irritates the cyst walls, causing inflammation, scarring, and a gradual collapse of the abnormal blood vessels. Over time, this reduces the size of the lesion and alleviates swelling, leakage, and difficulty eating or speaking. Sclerotherapy is performed under general anesthesia, and multiple sessions may be needed for optimal results.

Surgical Resection

In some cases, surgical removal may be necessary, especially if you have microcystic or mixed (macro- and microcystic) lesions that do not respond well to sclerotherapy. Surgery is done to remove as much of the abnormal tissue as possible while preserving structures like nerves and muscles. Macrocystic lesions can often be cured with surgery, while microcystic lesions may require multiple operations due to a higher chance of recurrence. Our surgeons, led by Dr. Waner and Dr. O, help achieve optimal functional and cosmetic outcomes.