Review ArticlesMassive Localized Lymphedema Review of an Emerging Problem and Report of a Complex Case in the Mons PubisBrewer, Michael B. MD; Singh, Devinder P. MDAuthor Information From the Division of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, MD. Received August 26, 2010, and accepted for publication, after revision, January 20, 2011. Conflicts of interest and sources of funding: none declared. Reprints: Devinder P. Singh, MD, University of Maryland Medical Center, Division of Plastic Surgery, Suite S8D18, 22 South Greene St, Baltimore, MD 21201. E-mail: [email protected]. Annals of Plastic Surgery: January 2012 - Volume 68 - Issue 1 - p 101-104 doi: 10.1097/SAP.0b013e318211910e Buy Metrics Abstract Massive localized lymphedema (MLL) is an emerging complication of the obesity epidemic. Caused by the obstruction of lymphatics, MLL presents as a giant swelling, with characteristic skin changes, and often lymphatic weeping. MLL has also been called “pseudosarcoma” because of its morphologic and pathologic similarity to sarcoma. Left untreated, MLL can degenerate into angiosarcoma. We present a case of MLL of the mons pubis in a 40-year-old man with a body mass index of 69. The literature is reviewed and an additional 40 cases of MLL are described. We found a female predominance of 1.6 to 1, an average weight of 421 lbs, and a 58% majority of cases in the thigh. © 2012 Lippincott Williams & Wilkins, Inc.