Surgical management of 'lymphangioma circumscriptum'

The results of surgery in 29 patients with 'lymphangioma circumscriptum' have been reviewed 2-8 years after operation. They show that in regard to management there are two varieties: small lesions, less than 7 cm diameter, in favourable sites of the body, which are potentially curable; and large lesions, greater than 7 cm diameter on the skin with an even larger area of subcutaneous cysts, in which complete excision of all the skin and subcutaneous vesicles would require skin grafting. Nine patients had small lesions excised. Seven have had no recurrence. Twenty patients had large lesions treated by a radical excision of all or as much of the cyst bearing subcutaneous tissues and skin as possible, but leaving enough skin to permit a primary suture, even though it meant leaving skin vesicles. The lesion was controlled and the cosmetic appearance improved in 16 patients. Subsequent regression of many of the vesicles not excised supports the aetiological hypothesis of the skin lesions proposed by Whimster.