Chemotherapy for postmastectomy lymphangiosarcoma

Abstract

Twenty-two patients with postmastectomy lymphangiosarcoma have been seen at M. D. Anderson Hospital during the past 20 years. Of these, 13 received chemotherapy, either regionally, systemically, or both. Six patients were treated with regional chemotherapy using either methotrexate alone, a combination of melphalan, nitrogen mustard, and actinomycin D, or a combination of melphalan with nitrogen mustard or actinomycin D; 3 achieved a partial or complete response. Eleven patients received 19 trials of systemic chemotherapy; one complete and seven partial responses were observed, giving an overall response rate of 42% (8/19). Responses occurred with 5-fluorouracil, methotrexate, a combination of vincristine, actinomycin D, and cyclophosphamide, and a combination of Adriamycin and dacarbazine with or without vincristine. The median survival time of the six patients who responded to at least one chemotherapeutic trial was 26.5 months compared with four months for the five patients who failed to respond. These data indicate that chemotherapy may play a significant role in the treatment of patients with this rare but distinctive tumor. Cancer 47:853-856, 1981. YMPHANGIOSARCOMA OCCURRING AFTER RADICAL

Stewart-Treves syndrome: Pathogenesis and management

“…Others reported ranges between radical mastectomy and onset of lymphangiosarcoma of 5 to 16 years with a mean onset of 11 years. 27,28 Lymphedematous changes are necessary for the development of Stewart-Treves syndrome. The lymphedema occurs with no history of complications such as postoperative infection or thrombosis.…”

Lymphangiosarcoma in a Dog Treated with wurgery and Chemotherapy

“…Histological features of these cases, mainly consisted of cystic spaces lined by endothelial cells, were similar to those of lymphangioma which also developed lymphedema [2,10]. It is unclear in dogs whether lymphedema is a cause of LAS or a result from it [1,6], although chronic lymphedema is considered to be the important cause of LAS in humans [12].…”

“…Radiation is reported to be effective in a dog with recurrent lymphangioma [10] but uncertain in dogs with LAS. In humans, complete or partial response had been observed in the LAS patients receiving 5-fluorouracil, methotrexate, or doxorubicin combined with decarbazine [12]. Clinical improvement of lymphedema with LAS for about 5 months by the doxorubicin therapy has been reported in a 8-week-old dog [8].…”

“…4). Considering the highly invasive activity of the original tumor, the second surgery was not conducted and the owners consented to the trial chemotherapy based on the results of humans [12] and a dog [8].…”

Soft Tissue Sarcomas after Radiation Treatment for Breast Cancer Three Case Studies and Review of Literature

“…Yap et al [19] give the incidence as 0.07%, from a data base of over 9,000 breast cancer patients. It is almost always the homolateral arm which is affected, very rarely the chest wall or the contralateral arm.…”