A review of the surgical treatment of lymphangiectasia and vulval lymphangioma: four case reviews.

A review of the surgical treatment of lymphangiectasia and vulval lymphangioma: four case reviews.

J Plast Reconstr Aesthet Surg. 2006;59(12):1442-5. Epub 2006 Mar 9.

Makh DS,
Mortimer P,
Powell B.

Department of Plastic Surgery, Plastic Surgery Unit, St George's Hospital, London, SW17 ORE, UK.

OBJECTIVE: To evaluate whether surgical management of vulval lymphoedema and/or lymphangiectasia conveys any longstanding patient benefit.

PATIENT AND METHODS: A qualitative analysis of signs and symptoms that occurred before and after surgical treatment for vulval lymphoedema and/or lymphangiectasia was performed. This was done by analysis of patient notes and telephone conducted interview.

RESULTS: From a hospital database search, four patients were found to have had surgical treatment - three for lymphangioma and one for lymphangiectasia. Overall there was a clear improvement in the signs and symptoms associated with these conditions. In particular, all patients reported an improvement (i.e. a reduction or elimination) in the amount of oedema following surgery.

CONCLUSION: Carbon dioxide laser therapy and superficial radiotherapy have been previously described for the management of vulval lymphangioma and lymphangiectasia with limited success, whereas our data suggests surgery offers a more permanent solution. In particular, labial reduction seems to be more successful than methods such as lymphovenous anastomoses and lymphangioplasties. A single operation may provide benefit for up to ten years. This approach has the potential to allow patients to be rehabilitated to normal life and activity.

Article

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Vulval lymphangiectasia.

Handfield-Jones SE,
Prendiville WJ,
Norman S.

Department of Dermatology, Bristol Royal Infirmary, Bristol, UK.

Three cases of lymphangiectasia of the vulva are reported. One case followed Wertheim's hysterectomy for carcinoma of the cervix; two other cases had Crohn's disease with perineal involvement. Lymphangiectasia is a secondary phenomenon resulting from obstruction of previously normal lymphatics. This is in contrast with lymphangioma which is an anatomical abnormality. A review of the literature suggests that the vulval skin may be particularly susceptible to the formation of lymphangiectasia, and our patients' experiences suggest that they are easily mis-diagnosed.

PMID: 2684843 [PubMed - indexed for MEDLINE]

See Also:

Vulvar lymphangiectasias in Crohn's disease