There should be some hypothesis about the lymphatic failure mechanism in the present case. In usual cases, ICG flowing in the lymphatic vessels can move ahead with the support of manual lymph drainage even if the lymphatic vessel has pump failure. In the present case, ICG would not proceed despite our manual lymph drainage. The lymphatic vessel we found at that point intraoperatively, which is the next day of ICG lymphography, got sclerotic, not having an absolute lumen, and there was a dilation of the lymphatic vessel at the distal side. Therefore, we believe that there must have been some local occlusive mechanism in the lymphatic vessel. The mechanism lasted for about at least 12 hours, from the time of ICG lymphography to the operation, and it is not likely that it was due to a temporary lymphatic spasm.