A case of HPV and acquired genital lymphangioma: over-lapping clinical features Published online (EP) 25 March 2015 - Ann. Ital. Chir 1 Pervenuto in Redazione Dicembre 2014. Accettao per la pubblicazione Febbraio 2015 Correspondance to: Giovanni Cestaro, Via Pazzigno 6, 80146 Napoli (e-mail: giovacestaro@gmail.com) Giovanni Cestaro, Michele De Rosa, Maurizio Gentile, Salvatore Massa Dipartimento di Endocrinologia, Gastroenterologia e Chirurgia, Unità Operativa Complessa di Chirurgia Generale, Università degli Studi di Napoli Federico II, Napoli, Italy A case of HPV and acquired genital lymphangioma: over-lapping clinical features Lymphatic malformation or lymphangioma is a benign proliferation of the lymphatics accounting for 4% of all vascu- lar malformations and 26% of all benign vascular tumors. There are several reports about genital lymphangiomas mim- icking venereal lesions, such as genital warts. Hereby we described a case of a 24 year old man affected by multiple vesicles and warts in genital area. All hematological and biochemical parameters, Human Immunodeficiency Virus (HIV) and Treponema Pallidum tests, C1 - Inhibitor and C1 - Q values were within limits. An accurate fulguration and wide excision of bigger lesions were performed. Histological examination showed numerous dilated lymphatic vessels in the superficial dermis with infiltration of inflam- matory cells, that is a histopathological picture compatible with genital lymphangioma. Considering our clinical suspi- cion of condylomatosis, HPV (Human Papilloma Virus) Polimerase Chain Reaction (PCR) Genotyping, named INNO- LiPA test, was performed, that revealed a genital infection by HPV - genotype 6. We think that our case can be con- sidered an example of HPV infection and acquired genital lymphangioma overlap clinical syndrome. The patient pre- sented any lesions one year after the procedure at follow-up examination. KEY WORDS: Condyloratosis, HPV cenotyping, Lymphangion Another important distinction can be realized between congenital and acquired lymphangioma 4 . Congenital lymphangiomas result from a hamartomatous malforma- tion of lymphatic vessels, while acquired lymphangiomas are the results of acquired obstruction of lymphatic ves- sels induced by surgical or radiation treatment of neo- plasms of the breast or uterus, trauma, chronic inflam- mation, infection (e.g. Erysipelas, Tubercolosis) and oth- er unknown diseases. There are several reports about gen- ital lymphangiomas mimicking venereal lesions 5 . Indeed, considered those arising in other regions, lymphangiomas of genital and anal areas can be more hyperplastic, prob- ably due to the loose connective tissue, which can cause a cauliflowerlike aspect or some smooth and umbilicat- ed lesions, mimicking respectively genital warts or mol- luscum contagiosum 6 . Hereby we report a rare case of acquired genital and anal lymphangioma that showed excellent results follow- ing an adequate surgical treatment. Ann. Ital. Chir. Published online (EP) 25 March 2015 pii: S2239253X15023695 www.annitalchir .com Introduction Lymphatic malformation or lymphangioma is a benign proliferation of the limphatics accounting for 4% of all vascular malformations and 26% of all benign vascular tumors 1,2 . Based on the clinical and pathological charac- teristics, lymphangiomas are broadly classified as superfi- cial (circumscriptum) or deep (cavernous) 3 . There is any clear distinction between both and the only difference seems to be the extent of the malformation. Lymphangiomas also can be classified as simple, cavernous or cystic according to the size of the lymphatic vessels. READ-ONLY COPY PRINTING PROHIBITED