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Lymphangioma Circumscriptum of the Vulva Following Surgical and Radiological Therapy of Cervical Cancer

JAPPE, UTA MD, MsC; ZIMMERMANN, THOMAS MD; KAHLE, BIRGIT MD; PETZOLDT, DETLEF MD

Article

Background Lymphangioma circumscriptum of the vulva rarely develops after postoperative pelvic irradiation.

Goal The goal was to describe two cases of lymphangioma circumscriptum and their treatment and present a brief review of the literature.

Study Two female patients, aged 75 years and 46 years, presented with persistent edema, papules, and vesicles of the labia majora, which had developed 15 and 9 years after hysterectomy, lymph node dissection, and subsequent irradiation of cervical cancer. The external diagnosis was genital warts.

Results In both cases histology revealed lymphangioma circumscriptum of the vulva. Whereas the older woman's condition responded well to laser treatment, keloids developed in the second patient at the site of carbon dioxide laser vaporization.

Conclusion CO2 laser treatment recently has been recommended for vulvar lymphangioma circumscriptum and is effective in vaporizing the communicating vessels to deeper cisterns. To our knowledge this is the first description of keloid development after laser therapy for vulvar lymphangioma circumscriptum, and such an effect should be considered before CO2 laser surgery is applied for this particular entity.

Lymphangioma circumscriptum of the vulva after postoperative pelvic radiation is very rare and can be indistinguishable from genital warts. Keloids developed in one patient after laser therapy for vulvar lymphangioma circumscriptum, and such an effect should be considered before application of CO2 laser surgery for this particular entity.

From the Department of Dermatology and Venereology, University of Heidelberg, Heidelberg, Germany

The authors thank Prof. W. Hartschuh, consultant in histopathology, of the Department of Dermatology and Venereology, University of Heidelberg, for providing the histopathology report and photograph.

Reprint requests: Uta Jappe, MD, MSc, Department of Dermatology, University of Heidelberg, Vosstrasse 2, D-69115 Heidelberg, Germany. E-mail: Uta_Jappe@med.uni-heidelberg.de

Received for publication August 14, 2001,

revised December 11, 2001, and accepted December 12, 2001.

© Copyright 2002 American Sexually Transmitted Diseases Association