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B. Hegemann, P. Helmbold, W.cH. Marsch, Genital inflammatory lymphoedema: peculiar microvascular long‐distance metastasis of gastric carcinoma, British Journal of Dermatology, Volume 144, Issue 2, 1 February 2001, Pages 419–420, https://doi.org/10.1046/j.1365-2133.2001.04042.x
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Sir, We would like to show that inflammatory lymphoedema of the external genitals may be a presenting feature of gastric carcinoma. To the best of our knowledge only two other cases of secondary lymphoedema caused by gastric cancer have been reported, one of them affecting the lower extremities,1 the other the upper thoracic region after thoracic duct rupture.2
Four weeks prior to first admission, a 52‐year‐old male patient noted an increasing redness and swelling of the scrotum. Under the tentative diagnosis of ‘erysipelas’ he had received oral antibiotics without any success. On admission, the scrotum was intensely red, indurated and had a macerated surface. The induration reached the lower abdomen and the proximal upper limbs, respectively; the penis and praeputium showed a gross oedematous swelling (Fig. 1a). The patient, who was oligophrenic, reported no other complaints.
The erythema and the rapidly evolving induration were not consistent with conventional lymphoedema. Therefore, it was decided to take skin biopsies from the scrotum. These revealed dilated dermal lymphatic capillaries packed with tumour cells, which additionally were found in the interstitial space of the middle and lower dermis in plate‐like clusters. The tumour cells showed high‐grade nuclear pleomorphism and hyperchromatism (Fig. 1b). No additional histological stains were performed.
