title: Unilateral lower limb lymphedema resulting from a heart surgery performed 50 years prior.
abstract: BACKGROUND
  Lymphedema is classified into two main types: secondary lymphedema accompanied by lymph node excision surgery or radiotherapy; and idiopathic lymphedema. Here we experienced a very rare case of lymphatic edema resulting from cardiac surgery that the patient underwent 50 years previously.
  
  
  METHODS
  A 62-year-old woman experienced progressive unilateral lower leg lymphedema for recent years. After undergoing cardiac surgery at another hospital at the age of 12 years, she gradually developed left lower leg edema. The cause of the edema was unclear and it remained untreated. Her edema symptoms gradually worsened in recent years, so she consulted the plastic surgery division of our hospital.
  
  
  CONCLUSIONS
  Perhaps the lymphatic structures of affected individuals differ prior to disease onset. If the mechanism of lymphatic edema outbreak is elucidated, patients needing conservative and surgical therapy might be more easily identified. Knowing the outbreak mechanism of lymphatic edema would definitely ease the investigation of an unconventional case like this one. Conservative treatments for lymphedema, such as self-massage and compression therapy using garments, were immediately started. With these treatments, the leg volume and edema symptoms reduced.
  
  
  CONCLUSIONS
  The research on the cause of this case may be important step for elucidating the source of secondary lymphatic edema.
authors.affiliation: Department of Plastic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan. Electronic address: satoshiprs18@gmail.com.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Onoda
authors.affiliation: Department of Plastic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Miura
authors.affiliation: Department of Plastic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan.
authors.forename: Narushi
authors.initials: N
authors.lastname: Sugiyama
keywords: Conservative therapy; Lymphatic edema outbreak mechanism; Secondary lymphedema