Endoscopic injection sclerotherapy with doxycycline for mediastinal and esophageal lymphangiohemangioma

Background: Lymphangiohemangioma, also called lymphatic-venous or venolymphatic malformation, is a rare malformation of the lymphatics, with vascular elements. These are low-flow vascular lesions. Objective: To evaluate the feasibility and efficacy of endoscopic injection sclerotherapy with doxycycline for low-flow vascular malformations in the GI tract. Design: Case report. Setting: Academic center. Patients: An adult man with lymphangiohemangioma that involved the mediastinum and the esophagus. The esophageal involvement caused dysphagia and chest pain. Interventions: We characterized the lesion with EUS and successfully treated the esophageal and paraesophageal lesions with endoscopic injection sclerotherapy by using doxycycline. Main Outcome Measurement: Symptom resolution and complications. Results: The patient's esophageal symptoms resolved with sclerotherapy. This is the first reported case of lymphangiohemangioma with esophageal involvement and the first reported case of endoscopic injection sclerotherapy by using doxycycline in the GI tract. Limitations: Case report and short follow-up period. Conclusions: Endoscopic injection sclerotherapy with doxycycline for lymphatic and low-flow vascular malformations in the GI tract is feasible, easy, safe, and effective.