Huge Vulval Elephantiasis of Filarial Origin: Diagnosis by Exclusion

Abstract

Background: Elephantiasis is a rare disorder involving lymphatic channels of the affected part of the body. It is characterized by huge enlargement of the particular body part and likely to affect limbs, scrotum, and trunk. Genital elephantiasis, also known as esthiomene, is a rare dramatic end result of lymphatic obstruction. Although mainly associated with filariasis and sexually transmitted diseases such as lymphogranuloma venereum and donovanosis, it could also be an uncommon complication of tubercular lymphadenitis. Case: A 40-year-old multiparous woman presented with progressively increasing vulval swelling over a period of 3–4 years. The swelling was soft and huge. She was managed successfully by surgical excision with vulvoplasty. Other possible differential diagnoses were excluded, and ancillary tests were performed to reach a conclusive diagnosis of vulval elephantiasis on histopathology. Conclusion: Vulval elephantiasis due to filariasis is rare and diagnosis on histopathology is more often by exclusion.