Singh Jp, Tandon Megha, Khandelwal Rohan, Aeron Tushar, Jain Sidharth, Narayan Nikhil, Bamal Rahul, Kumar Yashwant, Srinivas S, Saxena Sunita
Department of Surgery, Vardhman Mahavir Medical College, Safdarjang Hospital, New Delhi, India.
J Med Case Rep. 2010;4:369. doi: 10.1186/1752-1947-4-369. Epub 2010 Nov 18.
Elephantiasis as a result of chronic lymphedema is characterized by gross enlargement of the arms, legs or genitalia, and occurs due to a variety of obstructive diseases of the lymphatic system. Genital elephantiasis usually follows common filariasis and lymphogranuloma venereum. It may follow granuloma inguinale, carcinomas, lymph node dissection or irradiation and tuberculosis but this happens rarely. Vulval elephantiasis as a consequence of extensive lymph node destruction by tuberculosis is very rare. We present two very unusual cases of vulval elephantiasis due to tuberculous destruction of the inguinal lymph nodes.
Two Indian women - one aged 40 years and the other aged 27 years, with progressively increasing vulval swellings over a period of five and four years respectively - presented to our hospital. In both cases, there was a significant history on presentation. Both women had previously taken a complete course of anti-tubercular treatment for generalized lymphadenopathy. The vulval swellings were extremely large: in the first case report, measuring 35 × 25 cm on the right side and 45 × 30 cm on the left side, weighing 20 lb and 16 lb respectively. Both cases were managed by surgical excision with reconstruction and the outcome was positive. Satisfactory results have been maintained during a follow-up period of six years in both cases.
Elephantiasis of the female genitalia is unusual and it has rarely been reported following tuberculosis. We report two cases of vulval elephantiasis as a consequence of extensive lymph node destruction by tuberculosis, in order to highlight this very rare clinical scenario.
慢性淋巴水肿导致的象皮肿表现为手臂、腿部或生殖器显著肿大，是由多种淋巴系统阻塞性疾病引起的。生殖器象皮肿通常继发于常见的丝虫病和性病性淋巴肉芽肿。它也可能继发于腹股沟肉芽肿、癌症、淋巴结清扫术或放疗以及结核病，但这种情况很少见。由于结核病广泛破坏淋巴结导致的外阴象皮肿非常罕见。我们报告两例极为罕见的因腹股沟淋巴结结核破坏导致的外阴象皮肿病例。
两名印度女性，分别为40岁和27岁，外阴肿胀分别在5年和4年期间逐渐加重，前来我院就诊。两例患者就诊时均有重要病史。两名女性此前均因全身性淋巴结病接受了完整疗程的抗结核治疗。外阴肿胀极大：在第一例报告中，右侧尺寸为35×25厘米，左侧为45×30厘米，重量分别为20磅和16磅。两例均通过手术切除并重建进行治疗，结果良好。两例在六年的随访期内均保持了满意的结果。
女性生殖器象皮肿并不常见，结核病后很少有报道。我们报告两例因结核病广泛破坏淋巴结导致的外阴象皮肿病例，以突出这种非常罕见的临床情况。
