A case of Stewart‑Treves syndrome occurring in the abdominal wall successfully treated with eribulin: A case report

Abstract

Angiosarcoma (AS) is a rare and aggressive tumor with high rates of local recurrence and distant metastasis. Stewart-Treves syndrome (STS) is defined as AS arising in the setting of chronic lymphedema, and is extremely uncommon in the lower abdominal wall. Eribulin mesylate (eribulin) is a non-taxane microtubule inhibitor that has been approved in Japan for treating soft tissue sarcoma. The current study reports the case of a 76 year-old woman with STS in the lower abdominal wall who exhibited an excellent response to eribulin. Having undergone surgery and postoperative radiation therapy (RT) for cervical cancer 12 years earlier, the patient presented with a mass in her left lower abdominal wall, where chronic lymphedema had developed. Contrast-enhanced computed tomography revealed multiple enhancing nodules in the left lower abdominal wall and edema of the subcutaneous tissues in the whole lower abdomen. A histologic analysis of the specimens revealed AS, and she was diagnosed as STS. A total of 3 cycles of combination chemotherapy with gemcitabine and docetaxel were administered, but the patient discontinued treatment owing to severe adverse events. RT was performed for the tumor, but multiple reddish nodules appeared in the whole lower abdominal wall 3 months later. At this point, eribulin administration was offered. After 4 cycles of treatment, there was a clear reduction in the size of the nodules. All lesions were stable, no new lesions had developed, and the side effects of treatment were minor over the course of 1 year. The results reveal that eribulin may serve as a potential therapeutic option for the treatment of STS.

A retrospective analysis of Stewart-Treves syndrome in the context of chronic lymphedema

“…Some studies have reported that microsurgery, immunotherapy, and drugs may be effective in STS treatment, but most treatment schemes still emphasize the importance of radical surgery in determining the survival rate of patients. 17 , 18 , 19 In a study conducted in Canada, the average age of the patients was 61.2 years, and the average time from lymphedema to malignancy was 15.8 years. A total of 69.8% of the patients had a history of malignancy, and 53.7% had a history of radiotherapy.…”

New molecular targets in canine hemangiosarcoma—Comparative review and future of the precision medicine

“…209 The next four examples describing promising response in cASs appeared in 2018 [214][215][216] with one surprisingly successful outcome of chronic lymphoedema induced AS of the abdominal wall. 217 Less optimistic were the results for a case of intimal AS from the common iliac artery, where ERB treatment did not prevent tumour progression. 218 Currently ongoing phase II clinical trial aimed to asses safety and effectiveness of ERB in AS and epithelioid hemangioendothelioma treatment is recruiting.…”

“…At first, metastatic cardiac AS has been successfully controlled with ERB implemented as the eighth line of treatment 209 . The next four examples describing promising response in cASs appeared in 2018 214–216 with one surprisingly successful outcome of chronic lymphoedema induced AS of the abdominal wall 217 . Less optimistic were the results for a case of intimal AS from the common iliac artery, where ERB treatment did not prevent tumour progression 218 .…”

Stewart-Treves syndrome in an older woman successfully treated by metronomic chemotherapy: case report and literature survey

“…Classical mono-or combined chemotherapies are those usually applied in sarcomas: anthracyclines, paclitaxel, dacarbazine, bleomycin, and actinomycin D [4,5]. Eribulin has recently demonstrated some activity even in second-line treatment [8]. In selected cases, hyperthermic isolated limb perfusion with TNF-alpha/melphalan or mitoxantrone/paclitaxel combinations have been tried with some results [9,10].…”