Cavernous lymphangiomas involving bilateral labia major after caesarian section.

Sir,

Cavernous lymphangioma is an extremely rare benign mass in the vulva. In this study, we report a case of cavernous lymphangiomas involving the bilateral labia major after caesarian section. A 31-year-old woman with a history of previous caesarian section, G2 L2 that was delivered by caesarian section seven months before, referred to Shahid Beheshti Hospital in 2011 with symmetrical vulvar lesion that was onset form five months ago. The lesion was a small red papule similar in appearance to nevus or angium in the bilateral labia major [Figure 1]. It was removed by punched biopsy. Physical examination was normal. She did not have any particular disease in the past, and no history of radiation therapy or any other pathology. Laboratory data was normal; histological diagnoses showed cavernous lymphangioma [Figure 2]. The management of these lesions depends on type, size, and anatomical location. Two cases of cavernous lymphangioma involving the unilateral labium majora in a young woman[1] and involving the bilateral labia minor were reported.[2] In previous studies, it was discussed that increase in estrogen and progesterone levels may play a role in cavernous lymphangioma; however, in this case it was seen that after caesarian section, estrogen and progesterone levels were decreased. Hence, it can be concluded that there are other factors that might affect this lesion. Further studies with more cases are required to make a fair conclusion.

Figure 1

Histological examination of cavernous lymphangioma of labia majora. This section reveals cavernous vessels in the dermis that contain only lymph without any red blood cells

Figure 2

Gross picture of bilateral cavernous lymphangioma of thein labia majora