Lymphangioma circumscriptum of the vulva following surgical and radiological therapy of cervical cancer

Background: Lymphangioma circumscriptum of the vulva rarely develops after postoperative pelvic irradiation. Goal: The goal was to describe two cases of lymphangioma circumscriptum and their treatment and present a brief review of the literature. Study: Two female patients, aged 75 years and 46 years, presented with persistent edema, papules, and vesicles of the labia majora, which had developed 15 and 9 years after hysterectomy, lymph node dissection, and subsequent irradiation of cervical cancer. The external diagnosis was genital warts. Results: In both cases histology revealed lymphangioma circumscriptum of the vulva. Whereas the older woman's condition responded well to laser treatment, keloids developed in the second patient at the site of carbon dioxide laser vaporization. Conclusion: CO₂ laser treatment recently has been recommended for vulvar lymphangioma circumscriptum and is effective in vaporizing the communicating vessels to deeper cisterns. To our knowledge this is the first description of keloid development after laser therapy for vulvar lymphangioma circumscriptum, and such an effect should be considered before CO₂ laser surgery is applied for this particular entity.