title: Massive localized lymphedema revisited: a quickly rising complication of the obesity epidemic.
abstract: Massive localized lymphedema (MLL) is a rising and potentially fatal complication of the obesity epidemic. Described as a benign lymphoproliferative overgrowth of obese patients, MLL is a form of secondary lymphedema, caused by the obstruction of lymphatic flow, with characteristic clinical and histological presentation. Patients have a large mass with classic skin changes often accompanied by lymphatic weeping that require complex reconstruction. Although oftentimes benign, if left untreated, MLL can progress to angiosarcoma, further supporting the need for more research into MLL and its sequelae. We present a unique case of MLL of the mons pubis in a 52-year-old man with a body mass index of 75.7 kg/m. The literature was comprehensively reviewed with a total of 65 cases of MLL being described, 9 of which resulted in angiosarcoma (10.3% of all cases), 6 of which resulted in death (9.2% of all cases). We found a female predominance of 1.24 to 1, an average weight of 183 kg, and a 48.5% majority of cases in the thigh.
authors.affiliation: From the *Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine; †Division of Plastic Surgery, University of Maryland Medical Center, Baltimore, MD; and ‡University of Illinois at Chicago College of Medicine, Chicago, IL.
authors.forename: Karan
authors.initials: K
authors.lastname: Chopra
authors.forename: Kashyap K
authors.initials: KK
authors.lastname: Tadisina
authors.forename: Michael
authors.initials: M
authors.lastname: Brewer
authors.forename: Luther H
authors.initials: LH
authors.lastname: Holton
authors.forename: Abhishake K
authors.initials: AK
authors.lastname: Banda
authors.forename: Devinder P
authors.initials: DP
authors.lastname: Singh
mesh_terms: D006801:Humans; D008209:Lymphedema / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*