A 25-year-old woman presents with progressive swelling of the left leg since childhood. The swelling is non-pitting, involves the foot and leg up to the knee, and there is no history of infection, surgery, or trauma. Her mother had similar leg swelling. What is the most likely diagnosis?

• A Secondary lymphedema due to filariasis
• B Chronic venous insufficiency
• C Primary lymphedema (Milroy disease) ✓
• D Deep vein thrombosis

Explanation

Milroy disease is congenital familial lymphedema presenting at birth or early childhood, often with a positive family history, caused by mutations in the FLT4 gene. The non-pitting nature, absence of secondary causes, and family history distinguish it from secondary lymphedema. Chronic venous insufficiency typically presents later with skin changes and ulceration. Filariasis is endemic and acquired.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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