Abstract

Introduction: Lymphoedema is defined as accumulation of lymph in the soft tissue due to obstruction of lymphatics resulting in accumulation of protein rich interstitial fluid. This accumulated lymph activates fibroblasts and mast cells leading to organization of oedema fluid and sclerosing fibrosis of subcutaneous tissue which gives rise to firm, non pitting and irreversible swelling associated with hyperkeratosis, verrucous and condylomatous changes. These features of long-standing lymph stasis are collectively called as Elephantiasis. Here we present a rare case of vulval filariasis in a 14-year-old unmarried female.

Case Presentation: Miss. XXX, a 14-year-old unmarried female, resident of Babupurva, Kanpur, presented to the OPD, Department of General Surgery, L.L.R hospital, Kanpur   with complaints of growth over vulva for the past 11 years. The swelling which was initially the size of a pea was first noticed by her mother when she was 3 years old and assumed it to be a boil. The swelling gradually increased in size. However, the patient neglected it. Patient gave history that the swelling rapidly increased in size over the past three years to attain the present size. General examination and systemic examination was normal. The patient attained menarche 2 years back. Local examination revealed a 9x7 cm boss elated elliptical pendulous mass projecting between the labia obstructing the vulval cleft. The skin over the mass was hard, thickened, hyperpigmented and had extensive rugosities. The mass was also non-pitting and non-tender.

Conclusion: Asvulval elephantiasis is a very rare entity today, we have compiled this case report to present the findings collected and shine light on the treatment protocols of a very rare diagnosis.