Background: Lymphedema is the result of the equilibrium between the load to be cleared and the transport capacity of the clearing system. Lymphedema may be classifi ed as primary or secondary, based on
the underlying etiology. Primary lymphedema is an unusual disorder characterized by inadequate
lymphatic drainage. Lymphedema tarda is a rare form of primary lymphedema.
Case Report: The case of lymphedema tarda documented here was chronic, progressive, and resistant to medical therapy and recurred several times after previous operations.
Conclusions: We performed two-staged operations and we recommend that the staged excisional procedures
offers reliable long-term improvement and minimizes postoperative complications in chronic advanced
lymphedema.

Keywords: Chronic Disease, Follow-Up Studies, Lower Extremity - surgery, Lymphedema - surgery, Physical Therapy Modalities, Recurrence, Time Factors