A rare case of lymphangiomacircumscriptum of the scrotum

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LymphangiomaCircumscriptum (LC) is a lymphatic malformation resulting from a
developmental anomaly of the lymphatic system. Common sites for the anomaly are trunk,
axilla, thigh, buttock area and the oral cavity but very rare in scrotal region. We present a case of
42 years oldNepali hindumale came to our department with complaints of slow growing,
painless, fluid-filled and grouped lesion in scrotum since last12 years. The lesion started from
right side of scrotum and was increasing to involve whole scrotum.There was no history of fever
and weight loss. There was no similar family history or significant sexual history. Medical and
surgical history was not significant. On examination: Multiple grouped vesicles was seen
covering almost entire scrotal skin with swelling of entire scrotum involving penis. The patient
visited multiple institutions for the given complain where he was prescribed various topical and
oral medications but without any improvement.
Baseline investigations and serology for sexually transmitted diseases were within normal limit.
There was no peripheral eosinophilia.
Skin punch biopsy was done and histopathology was sent which revealed mild acanthosis,
dilated lymphatic channel containing eosinophilic proteinaceous material extending from
papillary dermis to reticular dermis. There was no granuloma, endothelial swelling or adult
worm in section examined.
On the basis of history, clinical features and histopathological examination diagnosis of
lymphangiomacircumscriptum of scrotum was made and patient was referred to plastic surgery
for further management however, patient did not return to our institution for follow up.
Conclusion:

LC or microcystic lymphatic malformation of scrotum is a very rare abnormality of the
lymphatic channels of the skin. LC of scrotum may mask as a sexually transmitted disease in an
adult and should be diagnosed early in order to prevent complications and to remove
psychological impact in patient.
Key words:LymphangiomaCircumscriptum, Lymphatic malformation, Scrotum