Abstract: Objective To present a management protocal of extensive and deep space macrocystic LMs with percutaneous catheter bleomycin therapy and evaluate the clinical outcomes of children.Methods Four hospitalized children with deep space and gaint LMs were enrolled in the study conducted from Journal 2020 through May 2024 at Wuhan children’s hospital of Huazhong University of Science ＆ Technilogy (Wuhan China).Cases 1 and 2 were retropharyngeal lymphangiomas,cases 3 was extraperitoneal lymphangiomas with hemorrhage,and cases 4 were mesenteric lymphangiomas.They were all treated with bleomycin infusion for 2-3 times after subcutaneous catheterization and drainage of lymphatic fluid.Results Only case 4 had suffered a fever after bleomycin injection and improved after anti-infection.No complications occurred in the rest of the children.All the children were followed up for 3 to 12 months after the operation, and the tumors all shrank.Conclusion All of the patients were response good in deep space LMs with the treatment approach through percutaneous indwelling catheter sclerotherapy and repeated drug injection through the catheter can be used for treatment.

Key words: lymphangioma, retropharyngeal, mesentery, bleomycin