Pseudosarcoma: massive localized lymphedema of the morbidly obese

Massive localized lymphedema is a term used to describe a benign overgrowth of lymphoproliferative tissue in morbidly obese patients, which is characterized by fibrotic and edematous fibroadipose tissue. Because of its large size and similar appearance to sarcomas, it has often been termed a pseudosarcoma. Patients tend to seek treatment only when the masses reach a sufficient size to alter their activities of daily living or have problems with excoriation or wound breakdown. Resection is indicated in these cases or if there is any question as to underlying malignancy of the lesion. Although recurrence is common, overall prognosis is good, with only anecdotal reports of transformation to angiosarcoma in the literature. We report a patient afflicted with this unique disorder.