Intralesional Bleomycin for Orbital Venolymphatic Malformation

This retrospective case series evaluates the use of intralesional bleomycin injections in treating orbital venolymphatic malformations (OVLM). Three patients, a 7-year-old girl, a 37-year-old woman, and a 56-year-old man, presented with OVLM where the first two were recurrent cases with a history of failed sclerotherapy. All patients received multiple doses of intralesional bleomycin injections, resulting in significant reductions in lesion size, decreased proptosis, and pain relief. Although complete symptom resolution was not achieved, the injections were well-tolerated, and no ophthalmic or systemic side effects were reported. The findings suggest that bleomycin, a sclerosing agent inducing local inflammation and thrombosis, is an effective and safe treatment for OVLM, particularly in cases where excision is not feasible or previous therapies have failed. Intralesional bleomycin injections may offer a valuable alternative for managing this challenging condition.