# Impending Airway Threat in a Neonate: Intralesional Sclerotherapy As Salvage Therapy for Giant Congenital Cervical Cystic Hygroma

## TL;DR

A newborn with a large neck cyst causing breathing problems was successfully treated with a minimally invasive injection therapy instead of surgery.

## Contribution

Demonstrates intralesional sclerotherapy as a viable salvage therapy for giant congenital cervical cystic hygroma in neonates.

## Key findings

- Emergency ultrasound-guided bleomycin sclerotherapy significantly reduced lesion size in a neonate.
- No recurrence was observed at six-month follow-up.
- Highlights a safe and effective alternative to high-risk surgery for neonatal airway-threatening cystic hygromas.

## Abstract

Cervical cystic hygroma, or lymphatic malformation, is a rare congenital anomaly that can present as a life-threatening airway emergency in neonates. Prompt recognition and timely management are critical for survival. While surgical excision has traditionally been the mainstay of treatment, extensive lesions involving vital neck structures carry significant operative risks in the neonatal period. We report a full-term neonate presenting at birth with a giant cervical cystic hygroma causing airway compression and respiratory distress. Due to high surgical risk, emergency ultrasound-guided intralesional bleomycin sclerotherapy was performed, resulting in a marked reduction in lesion size. At the six-month follow-up, there was no recurrence. This case underscores the role of image-guided intralesional sclerotherapy as a safe, effective, and minimally invasive life-saving alternative for neonates with giant cervical cystic hygroma.