title: Recurrent vulvar lymphangitis cured with vulvectomy in a cervical carcinoma patient: a case report.
abstract: BACKGROUND
  Recurrent vulvar lymphangitis secondary to pelvic lymphadenectomy and radiation therapy can be a vexing clinical dilemma.
  
  
  METHODS
  A 55-year-old woman was initially treated with radical hysterectomy and 1 postoperative radiotherapy for cervical carcinoma in 1984. In 1987 she developed persistent vulvar, leg, and ankle edema; chronic vulvar pain; and recurrent vulvar cellulitis, which were ultimately attributed to group B Streptococcus. Despite long-term antibiotic therapy and compression stockings, the cellulitis was intractable. In June 2006 the patient underwent a bilateral simple vulvectomy with preservation of the clitoris and insertion of bilateral subcutaneous Jackson-Pratt drains. Her postoperative culture results revealed normal vaginal flora.
  
  
  CONCLUSIONS
  The patient's wounds healed very well, and she has had no further episodes of vulvitis or lymphangitis. The management of recurrent infections involving lymphedema can be difficult and cause complicated clinical issues.
authors.affiliation: Gynecologic Oncology Associates, Hoag Cancer Center, Newport Beach, California 92663, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Micha
authors.forename: Bram H
authors.initials: BH
authors.lastname: Goldstein
authors.forename: Mark A
authors.initials: MA
authors.lastname: Rettenmaier
authors.forename: Erin J
authors.initials: EJ
authors.lastname: Tinnerman-Minailo
authors.forename: John V
authors.initials: JV
authors.lastname: Brown
authors.forename: Stephanie N
authors.initials: SN
authors.lastname: McClellan
authors.forename: Bonnie V
authors.initials: BV
authors.lastname: Bock
mesh_terms: D002277:Carcinoma / Q000628:therapy; D002481:Cellulitis / Q000382:microbiology / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008205:Lymphangitis / Q000601:surgery*; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012008:Recurrence; D013290:Streptococcal Infections / Q000150:complications / Q000628:therapy; D013292:Streptococcus agalactiae; D002583:Uterine Cervical Neoplasms / Q000628:therapy; D014844:Vulva / Q000601:surgery*; D014845:Vulvar Diseases / Q000601:surgery*