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Stewart-Treves Syndrome in a Patient Following Mastectomy: A Case Report. REHABILITATION ONCOLOGY 2017. [DOI: 10.1097/01.reo.0000000000000056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Taşdemir A, Karaman H, Ünal D, Mutlu H. Stewart-Treves Syndrome after Bilateral Mastectomy and Radiotherapy for Breast Carcinoma: Case Report. THE JOURNAL OF BREAST HEALTH 2015; 11:92-94. [PMID: 28331699 DOI: 10.5152/tjbh.2015.1604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 01/15/2014] [Indexed: 11/22/2022]
Abstract
Stewart-Treves syndrome is an angiosarcoma that occurs because of chronic lymphedema, which in most cases is a complication after mastectomy with axillary node dissection and postoperative radiation. Prognosis for this rare tumor is poor. The best therapy is early and radical excision. Chronic lymphedema seems to be an important pathogenic factor. We report a 59-year-old patient with chronic lymphedema and lymphangiosarcoma of the left upper limb who had a left modified radical mastectomy with axillary node dissection and postoperative radiation nine years ago. Additionally, the patient underwent a right modified radical mastectomy with axillary node dissection and postoperative radiation one year ago. In this report, we present a case of Stewart-Treves syndrome after the patient was operated for bilateral breast carcinoma, a review of literature, and principles of treatment.
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Affiliation(s)
- Arzu Taşdemir
- Department of Pathology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Hatice Karaman
- Department of Pathology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Dilek Ünal
- Department of Oncology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Hasan Mutlu
- Department of Radiation Oncology, Kayseri Training and Research Hospital, Kayseri, Turkey
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Safini F, Naim A, Bouchbika Z, Benchakroun N, Jouhadi H, Tawfiq N, Sahraoui S, Benider A. [Stewart-Treves syndrome complicating chronic idiopathic lymphedema]. Pan Afr Med J 2014; 19:311. [PMID: 25883738 PMCID: PMC4393999 DOI: 10.11604/pamj.2014.19.311.5636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 11/01/2014] [Indexed: 11/11/2022] Open
Abstract
Le syndrome de Stewart-Treves (SST) est une entité rare, correspondant à un angiosarcome cutané compliquant un lymphoedème chronique. Il est de mauvais pronostic. Stewart et Treves ont rapportés en 1948, les premiers cas d'angiosarcome secondaire à un traitement du cancer du sein. Ce terme s'est généralisé pour regrouper l'ensemble des cas de lymphangiosarcome sur lymphoedème d'origine congénital héréditaire ou non héréditaire, post-traumatique ou post-infectieux. Le SST sur un lymphoedème idiopathique reste exceptionnel. Nous rapportons le cas rare d'une patiente présentant un lymphoedème chronique primitif idiopathique des quatre membres évoluant depuis l'adolescence et qui a développé un SST du membre supérieur droit. Elle a subi une amputation à mi- bras vu le caractère très évolué de la tumeur
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Affiliation(s)
- Fatima Safini
- Service de Radiothérapie-Oncologie, Centre hospitalier Ibn Rochd, Casablanca 1, quartier des hôpitaux 20360, Casablanca, Maroc
| | - Asmaa Naim
- Service de Radiothérapie-Oncologie, Centre hospitalier Ibn Rochd, Casablanca 1, quartier des hôpitaux 20360, Casablanca, Maroc
| | - Zineb Bouchbika
- Service de Radiothérapie-Oncologie, Centre hospitalier Ibn Rochd, Casablanca 1, quartier des hôpitaux 20360, Casablanca, Maroc
| | - Nadia Benchakroun
- Service de Radiothérapie-Oncologie, Centre hospitalier Ibn Rochd, Casablanca 1, quartier des hôpitaux 20360, Casablanca, Maroc
| | - Hassan Jouhadi
- Service de Radiothérapie-Oncologie, Centre hospitalier Ibn Rochd, Casablanca 1, quartier des hôpitaux 20360, Casablanca, Maroc
| | - Nezha Tawfiq
- Service de Radiothérapie-Oncologie, Centre hospitalier Ibn Rochd, Casablanca 1, quartier des hôpitaux 20360, Casablanca, Maroc
| | - Souha Sahraoui
- Service de Radiothérapie-Oncologie, Centre hospitalier Ibn Rochd, Casablanca 1, quartier des hôpitaux 20360, Casablanca, Maroc
| | - Abdellatif Benider
- Service de Radiothérapie-Oncologie, Centre hospitalier Ibn Rochd, Casablanca 1, quartier des hôpitaux 20360, Casablanca, Maroc
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Lymphangiosarcoma of the arm presenting with lymphedema in a woman 16 years after mastectomy: a case report. CASES JOURNAL 2009; 2:6887. [PMID: 19918554 PMCID: PMC2769324 DOI: 10.4076/1757-1626-2-6887] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2009] [Accepted: 08/12/2009] [Indexed: 11/29/2022]
Abstract
Lymphangiosarcoma following breast cancer is a relatively rare entity, with around 300 cases so far reported worldwide. Affecting the long term survivors of breast cancer, lymphangiosarcoma (Stewart-Traves Syndrome) has a high mortality rate. Since lympedema following radical mastectomy or axillary clearance and radiotherapy seems to be the main predisposing factor, further research regarding modifications in the surgical technique of axillary nodes dissection as well as the development of new chemotherapeutic agents effective in lymphangiosarcoma are required.
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Allan AE, Shoji T, Li N, Burlage A, Davis B, Bhawan J. Two cases of Kaposi's sarcoma mimicking Stewart-Treves syndrome found to be human herpesvirus-8 positive. Am J Dermatopathol 2001; 23:431-6. [PMID: 11801776 DOI: 10.1097/00000372-200110000-00008] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although angiosarcoma is the most frequent tumor arising in the clinical setting of chronic lymphedema, as in Stewart-Treves syndrome, Kaposi's sarcoma has also been reported in this setting, although rarely. We describe two women who developed Kaposi's sarcoma in the lymphedematous arm many years after surgery for breast cancer. Case 1 is a 92-year-old and Case 2 is an 81-year-old; they underwent left total mastectomy and axillary node dissection for infiltrating breast carcinoma in 1981 and 1982 respectively. At that time, neither patient received further treatment. Except for persistent lymphedema, both women did well until over fourteen years later when each noted the development of several purple asymptomatic plaques on the edematous arm. In both, the clinical diagnosis at the time of biopsy was angiosarcoma. However, histologic findings in both cases were typical for Kaposi's sarcoma. In addition, a nested polymerase chain reaction (PCR) for the detection of a 233bp segment of KSHV/HHV8 was performed on DNA extracted from the paraffin-embedded specimens and both cases were positive for this sequence. Histologic sections of both cases were also tested for KSHV by in situ hybridization and demonstrated a positive signal in the lesional cells in each case.
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Affiliation(s)
- A E Allan
- Pathology Services, Inc., Cambridge, Massachusetts 02139, USA
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Campanacci M. Epithelioid Hemangioendothelioma and Angiosarcoma. BONE AND SOFT TISSUE TUMORS 1999:1089-1096. [DOI: 10.1007/978-3-7091-3846-5_76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Caldwell JB, Ryan MT, Benson PM, James WD. Cutaneous angiosarcoma arising in the radiation site of a congenital hemangioma. J Am Acad Dermatol 1995; 33:865-70. [PMID: 7593798 DOI: 10.1016/0190-9622(95)90424-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We describe a patient in whom angiosarcoma developed at the site of a hemangioma that was treated during infancy with radiation for refractory thrombocytopenia. Our findings, along with those of the 10 reported cases from the world literature, are summarized. One third of angiosarcomas arise in the skin. They most often show one of three clinical patterns. First and most common is occurrence as a bruiselike lesion on the scalp or face of an elderly person. Second in frequency is the Stewart-Treves syndrome. Third and least common is angiosarcoma developing as a sequela of previous radiation therapy. The prognosis in general is poor, with a mean survival length of 24 months and a 5-year survival rate of 10%. Effective treatment relies on early diagnosis and wide-margin surgical excision.
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Affiliation(s)
- J B Caldwell
- Department of Dermatology, Walter Reed Army Medical Center, Washington, DC, USA
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Affiliation(s)
- C A Harwood
- Department of Dermatology, St. George's Hospital, London, United Kingdom
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Abstract
Children who present with unilateral or bilateral swelling of the legs are often suspected of having a deep venous thrombosis. The incidence of deep venous thrombosis in children is low and lymphoedema may be a more appropriate diagnosis. Lymphoedema can be primary or secondary. In childhood, primary lymphoedema is more common and may be seen associated with other congenital abnormalities, such as cardiac anomalies or gonadal dysgenesis. Primary hypoplastic lymphoedema is the most often encountered type. It is more common in girls, especially around puberty, and is typically painless. Atypical presentations produce diagnostic confusion and may require imaging to confirm the presence, extent, and precise anatomical nature of the lymphatic dysplasia. This article describes four patients presenting with limb pain and reviews the clinical features and imaging options in children with suspected lymphoedema.
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Affiliation(s)
- N B Wright
- Department of Radiology, Royal Liverpool Children's NHS Trust
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Benson PM, Pessoa CM, Lupton GP, Winton GB. Basal cell carcinomas arising in chronic lymphedema. THE JOURNAL OF DERMATOLOGIC SURGERY AND ONCOLOGY 1988; 14:781-3. [PMID: 3392316 DOI: 10.1111/j.1524-4725.1988.tb01163.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A unique case is presented of basal cell carcinomas arising in chronic lymphedema of the lower extremity. The lesions were successfully treated with the CO2 laser.
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Affiliation(s)
- P M Benson
- Department of Medicine, Walter Reed Army Medical Center, Washington, D.C. 20307-5001
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Yokoyama S, Nakayama I, Tsuji K, Nakamura T, Moriuchi A, Yamashita H. Electron microscopic observations of lymphangiosarcoma arising from chronic lymphedema. ACTA PATHOLOGICA JAPONICA 1983; 33:843-54. [PMID: 6624459 DOI: 10.1111/j.1440-1827.1983.tb02132.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Lymphangiosarcoma, so-called Stewart-Treves syndrome, originating from the edematous left leg after hysterectomy in a 53-year-old woman has been studied by light and electron microscopy. Histologically the tumor was composed of either vascular channels or solid nests of the neoplastic cells having a large hyperchromatic nucleus with a single or multiple prominent nucleoli. The inner surface of the vascular channels was lined by either single or several layers of identical cells. Erythrocytes were occasionally observed in the lumina of the vascular channels. By electron microscopy the maturation of the neoplastic cells differed considerably from one area to another even in the same section. The immature cells were clustered in groups and consisted of scanty cytoplasm and a large nucleus with prominent nucleoli, whereas some of the mature cells lining the lumina had rod-shaped tubulated bodies (Weibel-Palade bodies). Desmosomes were frequently observed between the neoplastic cells. Basal lamina was generally not continuous or not present although some vascular structures were completely surrounded by a basal lamina. An autopsy was performed but revealed no metastatic lesions in any organs or lymph nodes.
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