Lymphangioma of the forearm and hand.

Cases of cavernous lymphangioma of the forearm and hand were reviewed in five female and four male patients. The tumor was first observed at a median age of 2 weeks, and tissue diagnosis confirmed at a median of 1.75 years. At a median follow-up of 11 years, all patients were symptomatic, describing pain when the affected area was bumped, pain with use, swelling, and extremity weakness. Five patients had experienced a previously undescribed episodic pain syndrome of simultaneous pain, swelling, induration, erythema, and fever. All cases responded favorably to elevation, analgesics, and antibiotics. Nine patients underwent a total of 18 operative procedures, including incisional biopsy, excisional biopsy, and excision of recurrent tumor, with a 33% complication rate. In only one case did surgery eliminate a small superficial tumor of the thumb; all other patients had recurrence of the tumor. Following attempted excision of cavernous lymphangioma of the forearm and hand, tumor recurrence, hypertrophic scars, and persistence of symptoms may be anticipated.