Successful treatment of giant lymphatic malformation with symptomatic cutaneous vesicles by surgical excision and coverage with Integra®

Lymphatic malformations (LMs) are the consequence of errors during embryological development of the lymphatic system. Large diffuse lymphatic malformations are troublesome. They can affect different tissue planes, and depending on the anatomic location, they can cause significant esthetic disturbance and interfere with normal function. LMs with skin involvement often manifest as multiple vesicles that ooze, bleed, itch, and get easily infected causing cellulitis with intense pain and fever, resulting in frequent hospital visits and impaired quality of life. We report one such case of a giant mixed type LM in the right lower extremity of an 11-year-old boy. The goal of this article is to discuss the currently available treatment modalities for these complex cases and to describe the successful outcome after an initial treatment with combined sclerotherapy and lasertherapy followed by a definitive surgical excision and coverage with Integra® and skin grafts.