Summary
Introduction
Indocyanine green (ICG) lymphography studies have identified that one in three to
five patients with cancer-related lower extremity lymphoedema (LEL) demonstrated dermal
backflow extending to the gluteal region. This study aimed to further characterize
gluteal lymphoedema using contemporaneous magnetic resonance imaging (MRI).
Patients and methods
Twenty-eight patients with unilateral advanced LEL who underwent both ICG lymphography
and MRI prior to any surgical procedure were included in this study. The patients
were divided into two groups with/without gluteal lymphoedema by the presence of dermal
backflow on ICG lymphography. MRI was used to evaluate tissue changes.
Results
Ten patients demonstrated gluteal lymphoedema on ICG lymphography and had a higher
incidence of skin hypertrophy in the gluteal region. However, no difference in excess
leg volume was found between the two groups. A trend of increasing gluteal subcutaneous
tissue in the affected side was identified in patients with gluteal lymphoedema with
a median increase of 20% compared with an 11% increase in the non-gluteal lymphoedema
group. The excess gluteal subcutaneous tissue was positively correlated to ipsilateral
excess leg volume.
Conclusion
The gluteal lymphoedema group on ICG lymphography had skin thickening in the gluteal
region and was likely identified in the secondary cancer-related group. Surgical and
conservative management options for gluteal lymphoedema need to be considered in advanced
LEL.
Keywords
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Article info
Publication history
Published online: October 18, 2022
Accepted:
October 11,
2022
Received:
November 10,
2021
Footnotes
Presented at the 28th World Congress of Lymphology, International Society of Lymphology, Athens, Greece, 20–24 September 2021.
Identification
Copyright
© 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
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