Surgical resection of vulva lymphoedema circumscriptum

Abstract

Lymphangioma circumscriptum, a rare, benign disease that can be either congenital or acquired, involves the deep dermis and subcutaneous lymphatics. This study aims to analyse the efficacy of surgical resection of vulva lymphangioma circumscriptum (VLC). Between January 2000 and December 2008, eight consecutive women referred to our centre and treated surgically for VLC were included in the study. VLC was responsible for recurrent lymph oozing in seven cases. All women were treated by the same plastic surgeon specialising in lymphatic diseases. The first surgery was performed after a median interval of 5.4 years since VLC onset. The first cutaneous resection included the labia majora of all women and labia minora of five and clitoral hood of four. Five women experienced rapidly recurrent vesicles associated with lymph oozing and underwent resection again (once: two women, twice: three women). The second resection was performed 4-6 months after the first, whereas the third took place 1-6 years after the second. Five women had moderate and transitory post-surgical lymph oozing. After a median follow-up of 53 months after the last surgery, seven of the eight women were free from symptom. Surgical resection is an effective and well-tolerated therapy for VLC in most women. Lesion recurrence is frequent but resection can be repeated several times with no adverse effects.