Cutaneous lymphatic malformation of the penis and scrotum

Penile Lymphangioma: review of the literature with a case presentation

Background

Penile lymphangiomas are rare manifestations of lymphangiomas or lymphatic malformations which are more commonly found in the head or neck region of the body. Lymphangiomas are further categorized as lymphangioma circumscriptum, cavernous lymphangioma, cystic hygroma, or acquired lymphangiomas (also known as lymphangiectasia), based on their depth and etiology.

Results

A literature review revealed only 30 cases of penile lymphangioma between 1947 and March 30, 2018. Several causes were attributed to the acquired penile lymphangiomas, including trauma, phimosis, and infection. While penile lymphangiomas can be initially mistaken for an infection, a thorough history and physical examination is sufficient to clinically diagnose a lymphangioma of the penis. Historically, surgical excision has been the gold standard of treatment for this condition. When asymptomatic, patients may opt for conservative management with avoidance of mechanical trauma alone. Other physicians have revealed novel treatment plans to rid patients of their penile lymphangioma such as a staged laser procedure.

Conclusion

In this article, we elucidate the causes, symptoms, treatments, and outcomes associated with penile lymphangiomas found in the literature while also presenting the case of a 30-year-old African-American man diagnosed with acquired penile lymphangioma.

Acquired microcystic lymphatic malformation of the distal upper extremity mimicking verrucae vulgaris

An 18-year-old African American male with a history of congenital lymphedema of the right upper extremity presented for evaluation of multiple verrucous lesions on his right hand. Clusters of 2 to 4-mm dome-shaped vesicles were intermixed with scattered verrucous papules on the right forearm and the dorsal and palmar aspects of the hand. Histopathology of one the verrucous lesions showed well-circumscribed areas of dilated lymphatic vascular channels with lymph in the lumen. The patient was diagnosed with microcystic lymphatic malformation, verrucous type. This article reviews the literature regarding reports of this variant of microcystic lymphatic malformation in the pediatric population.

Scrotal lymphangiomatosis: a case report

Lymphangiomas are benign tumours of the lymphatic system, and there are several reported cases of scrotal lymphangioma in the literature to date. We report a rare case of multilocular cutaneous lymphangiomatosis treated with surgical excision (total scrotectomy and reconstruction using split-thickness skin grafts with vacuum-assisted closure dressing).

CO2 Laser Ablation of Lymphangioma Circumscriptum of the Scrotum

Lymphangioma circumscriptum (LC) is an uncommon skin condition characterized by large muscular-coated lymphatic cisterns that lie deep with in the subcutaneous tissue and communicate with dilated dermal lymphatics. Patients suffer from edema and lymphatic leakage. Surgical excision and reconstruction is the gold standard for therapy. However, this can be mutilating. The authors present a patient who suffered widespread disease of his scrotum who had excellent symptomatic relief by treatment with the CO(2) laser.

Lymphangioma of the penis: a rare anomaly

Lymphatic malformations are known to affect any part of the body. However, lymphangiomas involving the penile skin are rare. We report a case of a cutaneous lymphatic malformation of the penis.

A salvage surgical solution for recurrent lymphangioma of the prepuce

Treatment of lymphangioma circumscriptum of the prepuce is often technically demanding. Many different medical and surgical approaches have been described over the years, none of which has proved completely successful. We describe a case in which skin deficiency was a problem after prior multiple excisions of lymphangiomatous tissue. We decided to bury the degloved shaft in the scrotum. After 6 months the penis was raised and reconstructed using scrotal skin; this achieved satisfactory skin coverage. In such cases piliferous follicles can easily be dealt with at a later stage by cosmetic treatment. We believe this technical approach may be a valid alternative to conventional procedures (i.e. grafts and flaps) especially when extensive resection makes skin coverage particularly difficult.

Extensive lymphatic malformation of penis and scrotum

Lymphangioma circumscriptum is an uncommon condition of the skin and subcutaneous tissues characterized by localized patches of vesicles. The penoscrotal region is a rare site for its development. We present a case with an extensive onset of lymphatic malformation of the pubis and penoscrotal region that we treated with wide excision. Reconstruction was achieved with a split-thickness skin graft combined with residual scrotal skin advancement.