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Pulmonary artery intimal sarcoma has very poor prognosis, for which radical resection may be difficult. A 68-year-old man with pulmonary artery intimal sarcoma underwent bilateral pulmonary artery resection and replacement. At 31 months postoperatively, recurrence occurred at the anastomotic site of the right pulmonary artery. Therefore, he underwent right upper lobectomy and combined resection and reconstruction of the right pulmonary artery. The tumor was removed, while preserving the lungs as much as possible. He is still alive 42 months after the initial surgery.

Objective: Although collateral lymphatic vessels are known to develop in patients with lymphedema, little is known about their significance. In this study, we investigated truncal collateral lymphatic drainage pathways in patients with lower limb lymphedema using indocyanine green (ICG) lymphography. Methods: The ICG fluorescence images and clinical characteristics of 80 consecutive patients (160 lower limbs) with secondary leg lymphedema who underwent ICG lymphography between September 2020 and September 2022 were retrospectively reviewed. Results: Seven patients were identified to have a truncal collateral lymphatic drainage pathway starting in the lateral abdomen and running in the direction of the ipsilateral axillary lymph nodes. These patients had particularly severe symptoms of lymphedema around the thigh or abdominal region or had genital lymphedema. Conclusions: A truncal collateral lymphatic drainage pathway may be associated with severe lower limb lymphedema, particularly if involving the genitals.

Lymphoceles result from either trauma to the lymphatic vessels or after vein graft harvest, which occurs in 10% to 16% of patients. When a lymphocele persists despite conservative treatment, patients can experience undue distress. We have reported the case of successful treatment using lymphatic venous anastomosis (LVA) of an intractable lymphocele that had been refractory to conservative treatment, including stretch bandaging, drainage, and local injection for 2 years after great saphenous vein harvest. The lymphocele resolved shortly after the LVA without any adverse effects. LVA can be a useful and minimally invasive alternative treatment of lymphocele after harvesting the great saphenous vein.

We describe a dementia patient with comorbid recurrent cellulitis and lymphedema in the left lower limb who was treated successfully for recurrent cellulitis by lymphaticovenular anastomosis (LVA). The patient, an 83-year-old woman, suffered from recurrent cellulitis three times a year on average for 15 years. Compression therapy was impossible because of dementia. After LVA, there has been no recurrence of cellulitis for 2 years.It is difficult to administer decongestive lymphatic therapy in some patients, such as patients with dementia. LVA is a promising treatment for recurrent cellulitis in a dementia patient with lymphedema.