Massive localized lipolymphedema pseudotumor in a morbidly obese patient

We describe a 31 year old man with a massive localized tumor-like lipolymphedema, a puzzling entity that afflicts the morbidly obese. The 281 kg man presented with a growing ulcerated bleeding mass located on his proximal medial thigh and suspicious for sarcoma. After en bloc resection of the 28.2 kg edematous mass, no evidence of neoplasm was found, only prominent lymphatic vessel dilation and edema with large quantities of unremarkable adipose and connective tissue. The lesion conformed to the diagnostic criteria for massive localized lipolymphedema (MLL) pseudotumor.