Sirolimus as a therapeutic option for a large cervical hemolymphangioma: Report of two cases

Sirolimus has shown promise as a treatment for extensive lymphatic malformations, especially when surgical excision is not feasible due to size, infiltration, or location. Although the literature remains limited and heterogeneous, most studies report partial clinical responses and pain relief, with few cases of complete remission. Adverse effects are generally manageable but can necessitate dose adjustments or discontinuation. The absence of standardized dosing guidelines and variability in treatment duration limit the comparability of published data. Despite these limitations, sirolimus represents a potentially effective and well-tolerated option, particularly for patients with complex, refractory, or inoperable malformations. Individualized treatment plans remain essential, taking into account lesion characteristics, patient age, and potential risks. Further high-quality studies are needed to establish optimal dosing regimens, safety profiles, and long-term efficacy.