Acquired lymphangiectasis following surgery and radiotherapy of breast cancer

Abstract

Acquired lymphangiectasia (AL) is a significant and rare complication of surgery and radiotherapy. We report lymphangiectasia in a 40-year-old woman who had undergone radical mastectomy and radiotherapy. After 4 years of combined therapy, she developed multiple vesicles and bullae. Skin biopsy confirmed the diagnosis of lymphangiectasia. The case is unique as it is not associated with lymphedema, which is a usual accompaniment of lymphangiectasia following surgery and radiotherapy. AL is usually asymptomatic, but trauma may cause recurrent cellulitis. Treatment modalities include electrodessication, surgical excision, sclerotherapy and carbon dioxide laser ablation.

Localized acquired lymphangiectasias after breast surgery: Enhanced non‐invasive diagnosis using dermoscopy and reflectance confocal microscopy

“…Acquired lymphangiectasias have been reported in the literature with an increased frequency in the past years due to increase in surgery for certain malignancies involving breast, male and female genitalia, and/or other internal organs …”

“…They clinically appear as clusters of asymptomatic, translucent, and flesh‐colored vesicular lesions; some of them may turn purple due to the presence of red blood cells . Lymphangioma circumscriptum is the most common congenital form whereas acquired lesions, known as lymphangiectasias, resulting from damage and/or obstruction of previously normal lymphatics, usually develop secondary to surgery, radiotherapy, and/or infections . In this case, clinical presentation may range from few, isolated vesicles measuring 2‐10 mm in diameter on normal‐appearing skin, to several, clustered, sometimes verrucous, lesions associated with diffuse lymphedema .…”

“…In this case, clinical presentation may range from few, isolated vesicles measuring 2‐10 mm in diameter on normal‐appearing skin, to several, clustered, sometimes verrucous, lesions associated with diffuse lymphedema . In 1956, acquired lymphangiectasias (ALs) were first described as a complication of radical mastectomy and several reports have been published so far . Diagnosis of ALs is usually clinical, although histopathologic confirmation is often required as they may mimic different disorders including epidermal nevi, angiokeratoma, basal cell carcinoma, cutaneous metastases, molluscum contagiosum, herpes virus infection, warts, and immunobullous diseases …”

A Case of Acquired Lymphangiectasia Mimicking Cutaneous Metastasis

“…This patient, diagnosed histopathologically with cutaneous acquired lymphangiectasia was presented in accompanation of the literature. 2,3,9 Bunların ortak özelliği, hepsinde lezyonların cerrahi girişim ve radyoterapi sonrasında gelişmesidir. Bu olguda da benzer olarak cerrahi girişim ve radyoterapi öyküsü mevcuttu.…”

“…2,9 Valdes ve ark.nın olgusunda lezyonların eritemli papüller şeklinde olduğu, ayrıca bu klinik görünüme lenfödemin de eşlik ettiği bildirilmiştir. 3 Bu olguda da benzer şekilde lezyonlar eritemli parlak papül-ler şeklinde idi, ancak farklı olarak lenfödem kliniğe eşlik etmiyordu.…”