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CC BY 4.0 · Arch Plast Surg 2023; 50(06): 615-620
DOI: 10.1055/a-2140-8589
Extremity/Lymphedema
Case Report

Massive Localized Abdominal Lymphedema: A Case Report with Literature Review

Badri Gogia 
1   Department of Herniology and Plastic Surgery, A.V. Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
,
Irina Chekmareva 
2   Department of Morbid Anatomy, A.V. Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
,
Anastasiia Leonova 
3   Department of the Interventional Endoscopy, A.V. Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
,
Rifat Alyautdinov 
1   Department of Herniology and Plastic Surgery, A.V. Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
,
Grigory Karmazanovsky 
4   Department of Radiology and Magnetic Resonance Imaging, A.V. Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
,
Andrey Glotov 
2   Department of Morbid Anatomy, A.V. Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
,
Dmitry Kalinin 
5   Department of Morbid Anatomy, A.V. Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
› Author Affiliations Funding None.
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Abstract

Massive localized lymphedema (MLL) is a rare disease caused by the obstruction of lymphatic vessels with specific clinical morphological and radiological characteristics. People with morbid obesity are mainly affected by MLL. Lymphedema is easily confused with soft tissue sarcoma and requires differential diagnosis, both the possibility of an MLL and also carcinoma manifestations in the soft tissues. The possible causes of massive lymphedema include trauma, surgery, and hypothyroidism. This report is the first case of MLL treated surgically in the Russian Federation. Detailed computed tomography (CT) characteristics and an electron microscope picture of MLL are discussed. A 50-year-old woman (body mass index of 43 kg/m2) with MLL arising from the anterior abdominal wall was admitted to the hospital for surgical treatment. Its mass was 22.16 kg. A morphological study of the resected mass confirmed the diagnosis of MLL. We review etiology, clinical presentation, diagnosis, and treatment of MLL. We also performed an electron-microscopic study that revealed interstitial Cajal-like cells telocytes not previously described in MLL cases. We did not find similar findings in the literature. It is possible that the conduction of an ultrastructural examination of MLL tissue samples will further contribute to the understanding of MLL pathogenesis.

Keywords

massive localized lymphedema - pseudosarcoma - soft tissue tumor - obesity - morphological study - Introduction

Authors' Contributions

B.G. conceived the study; contributed to the concept and design of the study; manuscript writing; approval of the final version; fully responsible for the content.

I.C. assisted with EM study and analysis; data interpretation; manuscript writing.

A.L. helped in manuscript writing; contribution to the concept and design of the study.

R.A contributed to the concept and design of the study; manuscript writing.

G.K. assisted with Radiology study and analysis, data interpretation; contribution to the concept and design of the study; manuscript writing.

A.G assisted with histological study and analysis, data interpretation; manuscript writing.

D.K. contributed to the concept and design of the study; manuscript writing.


Ethical Approval

This is a case report without personal data or personal figures of the patient. Therefore, no ethical approval is required.


Patient Consent

Written informed consent was obtained from the patient for the publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request.




Publication History

Received: 15 February 2023

Accepted: 04 July 2023

Accepted Manuscript online:
26 July 2023

Article published online:
30 November 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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