A giant lymphangioma circumscriptum on the anterior axilla: A case report

Lymphangioma is a rare benign proliferative lymphatic lesion that appears in chronic lymphedematous states in a variety of settings. Lymphangioma circumscriptum consists of clinically thin-walled, translucent vesicles appearing in groups most commonly located on the axilla, chest, mouth, and tongue. A 12-year-old male patient had been suffering from itching, pink-red colored, translucent vesicular lesions overlying the anterior axilla since birth. The lesions had slowly grown in size and number over the years. The patient had no history of trauma, or cellulites. The physical examination revealed clusters of pink-red colored vesicles, which released a clear exudate when punctured. The lesion was 50×120 mm in size. The lesion was totally excised and repaired with Z-plasty. Histopathological examination revealed slight epidermal acanthosis and enlarged lymph in the upper dermis, impinging directly onto the epidermis. These lymphatics were lined only by endothelium. The lower dermis and sub-cutis contained abnormally large muscle-coated vessels containing a proteinaceous fluid. Six months later, there was no recurrence and a cosmetically and functionally acceptable postoperative result was obtained.