title: Surgical management of vulvar lymphangioma circumscriptum: two case reports.
abstract: OBJECTIVE
  To evaluate the efficacy of major labiaectomy as a surgical management of vulvar lymphangioma circumscriptum, we report two cases of this rare clinical entity.
  
  
  METHODS
  Two female patients, aged 56 and 68 years, presented with persistent edema of the lower limbs, papule-like condyloma of the labia majora, and lymph oozing from these papules of the vulva, which had developed 24 and 10 years, respectively, after radical hysterectomy with adjuvant pelvic radiation therapy for cervical cancer. After major labiaectomy was performed, symptoms in the first case, of extensive resected skin margin, improved clearly, in the second case, vulvar lymphangioma circumscriptum was more severe than in the first case, and a small amount of lymph oozing occurred from residual papules of the labia majora. In both cases, histology revealed lymphangioma circumscriptum of the vulva.
  
  
  CONCLUSIONS
  Major labiaectomy is an effective therapy for vulvar lymphangioma circumscriptum. Particularly, in the case which was extensive and deep resected skin margin, symptoms such as papules of the labia majora and lymph oozing from these papules of the vulva associated with lymphangioma seemed to be clearly improved.
authors.affiliation: Department of Obstetrics and Gynecology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. ikedam@tokai-u.jp
authors.forename: Masae
authors.initials: M
authors.lastname: Ikeda
authors.forename: Toshinari
authors.initials: T
authors.lastname: Muramatsu
authors.forename: Masako
authors.initials: M
authors.lastname: Shida
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hirasawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishimoto
authors.forename: Shu-ichiro
authors.initials: S
authors.lastname: Izumi
authors.forename: Mikio
authors.initials: M
authors.lastname: Mikami
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D008202:Lymphangioma / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology / Q000473:pathology / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy / Q000601:surgery; D014846:Vulvar Neoplasms / Q000209:etiology / Q000473:pathology / Q000601:surgery*