SURGICAL TREATMENT OF PRIMARY LYMPHEDEMA COMPLICATIONS – A CASE REPORT
We present a case of a 28-year-old woman with primary lymphedema of the right leg, with tumor formations on her right foot, causing functional disabilities. Tumor formations were removed and histologically confirmed as dermatofibromas. Five years later, the patient was readmitted due to foot problems, keratosis of the heel, as well as increased edema of the dorsum of the foot and lower leg. Liposuction and excision of lymphoedematous tissue from the dorsum of the foot, release of the constrictive band at the level of the anterior surface of the ankle with "Z" plasty, as well as liposuction of lymphoedematous tissue of the lower leg and thigh were performed. The postoperative course was without complications, with a light seroma at the dorsum of the foot. During the 4-year follow-up period, the patient showed a noticeable improvement, with a slow increase in the volume of the lower leg and thigh, which did not reach the preoperative dimensions. Unfortunately, lymphedematous tissue increased again on the dorsum of the foot as prior to surgery.
Keywords: lymphedema, tumor, surgery
2.Keast DH, Despatis M, Allen JO, Brassard A. Chronic oedema/lymphoedema: under-recognised and undertreated. Int Wound J 2015;12:328-33.
3.Greene AK. Epidemiology and morbidity of lymphedema. In: Greene AK, Slavin SA, Brorson H, editors. Lymphedema Presentation, Diagnosis and Treatment. Switzerland: Springer; 2015. p. 33-50.
4.Ridner SH. Pathophysiology of lymphedema. Semin Oncol Nurs 2013;29:4-11.
5.International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology 2013;46:1-11.
6.Papadopoulou MC, Tsiouri I, Salta-Stankova R, Drakou A, Rousas N, Roussaki-Schulze AV, et al. Multidisciplinary lymphedema treatment program. Int J Low Extrem Wounds 2012;11:20-7.
7.Granzow JW. The current state of surgery for lymphedema. Surgery for Lymphedema. National Lymphedema Network (NLN) Lymph Link 2015;28:3-6.
8.Gallagher K, Marulanda K, Gray S. Surgical Intervention for Lymphedema. Surg Oncol Clin N Am 2018;27:195-215.
9.Granzow JW, Soderberg JM, Kaji AH, Dauphine C. Review of current surgical treatments for lymphedema. Ann Surg Oncol 2014;21:1195-201.