Penis & scrotum
Massively localized lymphedema in morbidly obese patients

Topic Completed: 1 May 2010

Minor changes: 28 October 2020

Copyright: 2002-2021,, Inc.

PubMed Search: Massive localized lymphedema obese

Alcides Chaux, M.D.
Antonio L. Cubilla, M.D.
Page views in 2020: 227
Page views in 2021 to date: 88
Cite this page: Chaux A, Cubilla AL. Massively localized lymphedema in morbidly obese patients. website. Accessed April 10th, 2021.
Definition / general
  • Benign tumor-like condition affecting the scrotum
  • Type of localized massive lymphedema
  • Scrotum, also thigh, popliteal fossa, abdomen, suprapubic and inguinal region
  • Obstruction of efferent lymphatic drainage by either massive abdominal pannus (usually patients weigh > 250 pounds) or prior surgery
  • Associated with hypothyroidism (Hum Pathol 2000;31:1162)
Clinical features
  • Huge mass resembling neoplasm (mean 50 cm, range 38 - 75 cm), of 9 months to 18 years duration
Gross description
  • Poorly defined, nonencapsulated
  • Skin indurated with peau d'orange appearance
  • Marbled appearance with fibrous bands intersecting adipose tissue lobules
Gross images

AFIP images

Massive scrotal edema

Microscopic (histologic) description
  • Lobules of adipose tissue intersected by fibrous bands
  • Lymphatic vascular ectasia, chronic inflammatory infiltrates, fibrosis, edema between collagen fibers, infarction and fat necrosis
  • May have floret-like giant cells or smooth muscle hyperplasia (Int J Surg Pathol 2011;19:212)
Differential diagnosis
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