Obesity Surgery

, Volume 16, Issue 9, pp 1126–1130

Massive Localized Lymphedema (MLL) in Bariatric Candidates

  • Miguel L A Modolin
  • Wilson CintraJr.
  • André O Paggiaro
  • Joel Faintuch
  • Rolf Gemperli
  • Marcus C Ferreira
Article
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Background: Mild lymphedema of lower limbs and eventually abdomen is not exceedingly rare in morbid obesity. However, few large symptomatic masses have been reported. In a consecutive series of patients, all requiring resection of the lesion before bariatric treatment, clinical features and surgical findings are described, aiming to clarify the nature of this intricate problem. Methods: Subjects (n=4, 50% females, age 34.0±13.7 years (19-53), BMI 56.4±10.5 kg/m2 (44.1-73.1) displayed lesions on the anteromedial aspect of the thigh (n=3) and hypogastrium (n=1). All reported episodes of intertrigo of local skin-folds in the preceding years, managed by local care and antibiotics. The mass was described as a serious nuisance, impairing walking, dressing and personal hygiene. Results: The mass was surgically removed without requirement for blood transfusion except in the case of one huge mass. Complications were relatively minor and consisted of partial skin dehiscence and lymph leakage for 2-3 weeks. Histologically, a complex pattern was observed including skin hypertrophy, edema, fibrosis, foci of microabscesses and dilated blood vessels, along with the pathognomonic lymphangiectasia. On follow-up to 6 months, improvement or restoration of the ability to walk occurred, with no additional skin infection and no recurrence. Conclusions: 1) Surgical treatment was effective. 2) Functional rehabilitation was achieved. 3) No recurrence was observed within the follow-up period.

LYMPHEDEMA MASSIVE LOCALIZED LYMPHEDEMA PSEUDOSARCOMA ELEPHANTIASIS NOSTRAS BARIATRIC SURGERY MORBID OBESITY 

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© Springer 2006

Authors and Affiliations

  • Miguel L A Modolin
    • Wilson CintraJr.
      • André O Paggiaro
        • Joel Faintuch
          • Rolf Gemperli
            • Marcus C Ferreira

              There are no affiliations available

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