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Lymphangioma circumscriptum (LC) is a benign condition where the tiny lymphatic vessels in the skin and the tissue just beneath it become abnormally dilated. These faulty vessels don’t connect properly with the rest of the lymphatic system, so lymph fluid pools instead of draining away1.
On the vulva it’s uncommon, but when it appears it shows up as small, clustered blister-like or wart-like bumps, sometimes described as looking like frog-spawn. They can leak clear or slightly blood-tinged fluid, and can be itchy, sore or prone to recurrent infection. It’s also known as microcystic lymphatic malformation.
Because the bumps can look like molluscum contagiosum or genital warts, a doctor confirms the diagnosis with an examination and, where needed, a small biopsy to rule those out2. LC also turns up on the mucosal surfaces of the mouth and tongue, and on the armpits, groin, chest and abdomen.
What causes lymphangioma circumscriptum
There are two broad types. Primary (congenital) LC is present from birth or early life, and why it develops isn’t fully understood. Acquired (secondary) LC develops later, after something damages the deeper lymphatic vessels.
On the vulva, the acquired form is the more common story, and it most often follows treatment for a pelvic or gynaecological cancer – surgery or radiotherapy that disrupts lymphatic drainage. In one review of acquired vulval cases, around half followed a previous cancer, and it was also linked with inflammatory bowel disease and long-standing lymphoedema3. Where it follows cancer treatment, LC is a benign late effect of that earlier surgery or radiotherapy – it is not a sign the cancer has come back.
The mechanism is the same whatever the trigger: lymph fluid collects in muscle-coated lymphatic pouches (cisterns) but can’t drain back into the system. The cisterns dilate and pulsate, pushing lymph up into the thin vessels of the skin, which makes the skin balloon into those little surface bumps.
Treatment for LC
There’s no single fix, and because the faulty vessels sit deep, LC has a real tendency to come back, so it’s often about management rather than a one-off cure.
Surgical removal (excision) is a common medical treatment, though it isn’t right for everyone. Other options aim to close off or destroy the abnormal vessels: sclerotherapy (irritating the vessel with a solution so it seals over), cauterisation, fulguration, radiofrequency4, and laser or light-based therapies.
A supportive, root-cause view
Since acquired LC is fundamentally a problem of lymphatic drainage, it’s worth looking at the underlying lymphatic picture alongside any medical treatment, with an appropriate practitioner.
Some approaches aim to support and strengthen the lymphatic system more generally, such as herbal medicine or acupuncture. These are supportive rather than a replacement for medical care, but they can be a useful part of the bigger picture.
When to see a doctor
Any new lump, bump or cluster of bumps on the vulva should be checked, both to confirm what it is and to rule out warts, molluscum or anything that needs attention. See a doctor sooner if the area is leaking fluid, becoming infected, painful, or changing.
Frequently asked questions
Is lymphangioma circumscriptum dangerous?
It’s a benign (non-cancerous) condition. The main problems it causes are leaking fluid, irritation and recurrent infection rather than anything dangerous in itself. That said, any new vulval bumps should be checked by a doctor to confirm the diagnosis.
Can it be cured?
It can be treated, but because the abnormal vessels sit deep in the tissue, LC often recurs after treatment. Most people manage it over time rather than clearing it in one go, and the approach is tailored to how much bother it’s causing.
Why did it appear on my vulva?
Vulval LC is often acquired, meaning it follows damage to the deeper lymphatic vessels – most commonly after surgery or radiotherapy for a pelvic or gynaecological cancer, and sometimes with inflammatory bowel disease or long-standing swelling in the area.
This article is general information and not a substitute for personalised medical advice. If you have new or changing vulval bumps, please see an experienced practitioner.
References
- Vlastos AT, Malpica A, Follen M. Lymphangioma circumscriptum of the vulva: a review of the literature. Obstetrics & Gynecology. 2003;101(5):946-954.
- Sinha A, Phukan JP, Jalan S, Pal S. Lymphangioma circumscriptum of the vulva: report of a rare case. Journal of Mid-life Health. 2015;6(2):91-93.
- Duong A, Balfour A, Kraus CN. Acquired vulvar lymphangioma: risk factors, disease associations, and management considerations: a systematic review. International Journal of Women’s Dermatology. 2023;9(2):e087.
- Omprakash HM, Rajendran SC. Lymphangioma circumscriptum (microcystic lymphatic malformation): palliative coagulation using radiofrequency current. Journal of Cutaneous and Aesthetic Surgery. 2008;1(2):85-88.
