Abstract
Background: Lymphatic malformations (LM) consist of fluid-filled cystic structures, which are formed due to failure of lymphatic vessels to connect with normal drainage pathways. Treatment is mainly aimed at the reduction of swelling and prevention of complications.
Case Presentation: A 2.7 kg full-term Saudi Arabian baby girl was delivered by spontaneous vaginal delivery with no postpartum complications. The pregnancy was uneventful aside from an antenatal pregnancy ultrasound illustrating a suspicious neck swelling. At the first assessment, the baby had a visible bilateral neck swelling which increased in size since birth. Moreover, the patient had recurrent respiratory tract infections and breathing difficulties. The patient was rushed to the pediatrics’ intensive care unit and a tracheostomy tube was inserted successfully. The computed tomography scan showed evidences of lymph-vascular (LM) malformation. The past medical record showed that the patient also suffered from fits and was put on an anticonvulsant (Levetiracetam). Also, the patient had a history of septic shock secondary to Klebsiella and Pseudomonas, for which the patient was given vancomycin and meropenem. Thus, the patient received two rounds of sclerotherapy with bleomycin injections and was planned to continue to receive multiple rounds. The patient’s lesion was clinically improved with small reduction in swelling size.
Conclusion: Cervicofacial lymph-vascular malformations are very rare, and they could be present at any age but usually in the early post-partum period.

Key words: Otolaryngology, vascular malformation, face and neck, sclerotherapy, lymphatic malformations, child