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Conflicts of interest: none declared.

Dear Editor, Massive localized lymphoedema (MLL) is a rare entity associated with morbid obesity. A 59‐year‐old woman with a body mass index of 57·2 kg m−2 presented for evaluation of a 2‐year growing mass on her left thigh (a). Computerized tomography of the mass revealed diffuse oedema in the subcutaneous tissues (b). Biopsy demonstrated superficial and deep perivascular dermatitis (c). D2‐40 immunostaining highlighted dilated lymphatic spaces (d). Taken together, the findings were consistent with MLL. After careful preoperative work‐up, the mass was surgically excised. The final pathology report was consistent with a diagnosis of MLL.

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