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Massive Localized Abdominal Lymphedema: A Case Report with Literature Review
Badri Gogia1, Irina Chekmareva2, Anastasiia Leonova3
1Department of Herniology and Plastic Surgery, A.V. Vishnevsky National Medical Research Center of Surgery, Moscow, Russia.
Archives of Plastic Surgery
|December 25, 2023
Summary
Massive localized lymphedema (MLL) is a rare condition often seen in morbid obesity. This report details the first surgical MLL treatment in Russia, including novel electron microscopic findings.
Area of Science:
- Medicine
- Pathology
- Surgery
Background:
- Massive localized lymphedema (MLL) is a rare condition characterized by lymphatic vessel obstruction, primarily affecting individuals with morbid obesity.
- MLL shares clinical and radiological features with soft tissue sarcoma, necessitating careful differential diagnosis.
- Potential causes include trauma, surgery, and hypothyroidism.
Purpose of the Study:
- To report the first surgical case of MLL in the Russian Federation.
- To detail the computed tomography (CT) and electron microscopy findings of MLL.
- To review the etiology, clinical presentation, diagnosis, and treatment of MLL.
Main Methods:
- Surgical resection of a massive localized lymphedema from the anterior abdominal wall.
- Morphological and histological examination of the resected mass.
- Electron microscopic study of the MLL tissue.
Main Results:
- A 50-year-old woman with a body mass index of 43 kg/m² underwent successful surgical treatment for MLL weighing 22.16 kg.
- Morphological studies confirmed the diagnosis of MLL.
- Electron microscopy revealed interstitial Cajal-like cells (telocytes), a novel finding not previously described in MLL.
Conclusions:
- Surgical intervention can be effective for massive localized lymphedema.
- The identification of telocytes in MLL offers new insights into its pathogenesis.
- Further ultrastructural examination of MLL tissues may enhance understanding of the disease's underlying mechanisms.
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