Intralesional injection of pingyangmycin is a safe and effective treatment for microcystic lymphatic malformations in the tongue.

Objective: To evaluate the efficacy and safety of intralesional injection of pingyangmycin for the treatment of microcystic lymphatic malformations (LMs) in the tongue.

Methods: Eighteen patients with tongue microcystic LMs were treated with intralesional injection of pingyangmycin. The concentration of the drug was 1 mg/mL with an addition of dexamethasone. Repeated injections were performed at an interval of 3–4 weeks. The results were evaluated by clinical examinations and Doppler ultrasonography scan. The follow-up period was 12 months to eight years after the last treatment and the mean follow-up time was three years. All patients received 1–8 injections (mean, 3.0 injections) for the whole course of treatment. The total dose of pingyangmycin administered was 8–64 mg (mean, 24 mg).

Results: Fifteen patients had complete response with no cosmetic or functional problems.Three patients with macroglossia had a reduction of 50–90% in the lesion size and needed secondary surgery. No serious complications were encountered.

Conclusions: The results suggested that intralesional injection of pingyangmycin is an effective and safe treatment for microcystic LMs in the tongue, and can be used as the first-line treatment protocol.