title: Benign lymphangiomatous papules of the skin associated with ovarian fibroma.
abstract: Benign lymphangiomatous papules of the skin are considered reactive lymphatic proliferations either caused by disruption of the lymphatic flow or tissue damage produced by operation or radiation therapy. We report a 72-year-old woman with umbilical papules and vesicle-like lesions that led to the diagnosis of a large ovarian fibroma. Histologic study revealed dilated lymphatic spaces manifesting an anastomosing and branched pattern in the papillary and reticular dermis dissecting collagen bundles. The vessels were lined by plump endothelial cells with foci of intravascular papillary endothelial cell hyperplasia. After the ovarian fibroma was removed by laparotomy, umbilical lesions almost disappeared, leaving small flesh-colored papules. A periumbilical dermatosis may herald certain intra-abdominal diseases including those of neoplastic derivation. A heightened awareness of this association may lead to an early diagnosis with a potential for improved patient outcome. Benign lymphangiomatous papules have not been previously described in association with an untreated tumor, without previous operation or radiotherapy. This case advocates for disruption of the lymphatic drainage as the probable pathogenetic mechanism.
authors.affiliation: Department of Dermatology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
authors.forename: Domingo
authors.initials: D
authors.lastname: Bodet
authors.forename: Laura
authors.initials: L
authors.lastname: Rodríguez-Cano
authors.forename: Ramon
authors.initials: R
authors.lastname: Bartralot
authors.forename: Jordi
authors.initials: J
authors.lastname: Mollet
authors.forename: Antonio
authors.initials: A
authors.lastname: Medina
authors.forename: Cristina
authors.initials: C
authors.lastname: Heras
authors.forename: Patricia
authors.initials: P
authors.lastname: Bassas
authors.forename: Pere
authors.initials: P
authors.lastname: Huguet
authors.forename: Vicente
authors.initials: V
authors.lastname: García-Patos
mesh_terms: D000368:Aged; D005260:Female; D005350:Fibroma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008202:Lymphangioma / Q000378:metabolism / Q000473:pathology*; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis*; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011860:Radiography, Abdominal; D012878:Skin Neoplasms / Q000378:metabolism / Q000473:pathology*; D014057:Tomography, X-Ray Computed