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
