When Vesicles Mislead: A Rare Case of Massive Lymphangioma Circumscriptum of the Vulva

Lymphangioma circumscriptum (LC) is a benign lymphatic malformation resulting from dilated lymphatic vessels in the skin and subcutaneous tissue. It commonly affects the chest, tongue, axilla, and oral cavity. Vulvar involvement is exceptionally rare.

We report the case of a 45-year-old multiparous female with a 4-year history of vulvar lesions along with discharge. There was no history of associated burning, pain, or itching. She underwent abdominal hysterectomy 10 months back (it was after the appearance of vulvar lesions). Local examination revealed grouped vesicles over the mons pubis and labia majora. Histopathology confirmed LC, showing dilated lymphatic spaces in the dermis.

The patient underwent surgical excision followed by daily dressings. Postoperative period was uneventful, with excellent cosmetic and symptomatic improvement.

Vulvar LC, although rare, should be kept in the differential diagnosis of vesicular or wart-like vulvar lesions. Early diagnosis and surgical intervention offer favorable cosmetic and psychosocial outcomes. This case highlights the importance of histopathological confirmation to distinguish LC from other similar presentations like genital warts or molluscum contagiosum.