Lymphangioma Circumscriptum: Review and Evaluation of Carbon Dioxide Laser Vaporization

Abstract

Three cases of the classical form of lymphangioma circumscriptum are described to illustrate the varied clinical manifestations of these lesions. The anatomy and physiology of cutaneous lymphangiomas are reviewed and their classification is clarified as a guide to their management. Treatment was sought by these patients in order to alleviate complaints of copious transudate of lymphatic fluid and chronic relapsing cellulitis. All three were treated with carbon dioxide laser vaporization with good to excellent cosmetic results and complete resolution of their symptoms. Carbon dioxide laser vaporization may be a useful alternative to frequently unsuccessful traditional surgical forms of therapy for selective cases of classical lymphangioma circumscriptum.

Use of a Myocutaneous Flap after Resection of a Large Lymphangioma

“…Suction-assisted lipectomy (10) with the intention of removing subcutaneous cysts was not practical. The use of carbon dioxide or tunable dye laser (5,17) is of benefit only in very localized forms of the ªlymphangioma circumscriptumº (12,13). Neodynium-YAG laser treatment with the interstitial placement of fibers has been shown to destroy subcutaneous lesions (14), yet the extension of the lymphangioma into the small pelvis excluded this therapeutic option.…”

Acquired Vulvar Lymphangioma Circumscriptum

“…The traditional treatment of LC—that is, surgical removal—is usually not successful due to rapid relapses and should be considered after treatment failures [8]. Vaporization with a CO 2 laser is a recent recommendation for lymphangioma circumscriptum of the vulva and is suggested to yield acceptable cosmetic results [9].…”

Combination technique of radiofrequency ablation with sclerotherapy in acquired lymphangiectasis of the vulva

“…[1415] In addition, surgical excision may not always be possible when wide areas are involved that can lead to distortion of normal anatomy of the vulva. Other modalities of treatment include electrocautery, CO 2 laser,[1516] Er:YAG laser. [17] There has been a report of keloid formation following CO 2 laser treatment.…”