Cutaneous Angiosarcoma Postmastectomy (Stewart-Treves Syndrome)

Degrieck, Bert; Crevits, Ilse

doi:10.5334/jbsr.1624

Cited by 3 publications

(2 citation statements)

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“…[ 1 ] It is associated with radiation treatment and chronic lymphedema following cancer treatment, but some cases are idiopathic. [ 2 , 3 ] Cutaneous angiosarcoma that presents as moderate- or high-grade lesions at diagnosis is common. Thus, early diagnosis and prompt surgery are essential to prolonging survival.…”

Section: Introductionmentioning

confidence: 99%

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Angiosarcoma secondary to postirradiation and chronic lymphedema

Yoon

Shin

et al. 2021

Medicine

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Introduction: Angiosarcoma secondary to post-irradiation and lymphedema is rare, but it is aggressive with a poor prognosis. It is essential to understand these patients’ clinical features and distinguish them from benign diseases or other malignant tumors. Patient concerns: Three patients who had radiotherapy for cancer treatment and chronic lymphedema admitted to the hospital with specific skin lesions at upper or lower extremities. Diagnosis: Excisional biopsies revealed prominent, highly atypical cells with a vasoformative area, composed of atypical, large epithelioid cells with vesicular nuclei, prominent nucleoli, and mitoses. Immunohistochemistry revealed diffuse expression of endothelial cell markers suggestive of angiosarcoma. Interventions: One patient had shoulder disarticulation with wide excision with adjuvant radiotherapy and chemotherapy and other 2 discontinued the treatment. Outcomes: After the treatment, one patient was transferred to rehabilitation department for shoulder disarticulation prosthesis fitting without recurrence sign for 1 year. Two patient refused further treatment and was lost to follow-up. Conclusion: In cases of patients with irratiation and chronic lymphedema, clinical findings suggestive of angiosarcoma, biopsy and imaging studies should be performed as soon as possible.

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Section: Introductionmentioning

confidence: 99%

“…The median survival time is 2.5 years, with 20% to 40% having distant metastasis at diagnosis [1] . It is associated with radiation treatment and chronic lymphedema following cancer treatment, but some cases are idiopathic [2,3] . Cutaneous angiosarcoma that presents as moderate- or high-grade lesions at diagnosis is common.…”

Section: Introductionmentioning

confidence: 99%

Angiosarcoma secondary to postirradiation and chronic lymphedema

Yoon

Shin

et al. 2021

Medicine

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Case for diagnosis. Stewart-Treves syndrome after mastectomy

Sato¹,

Pinto²,

Alves³

et al. 2022

Anais Brasileiros de Dermatologia

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Patient with composite haemangioendothelioma containing angiosarcoma-like areas in the setting of congenital lymphoedema mimicking Stewart-Treves syndrome: a case report

et al. 2023

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Background Composite haemangioendothelioma is a rare vascular neoplasm with indolent to intermediate malignant potential. Diagnosis of this disease relays on histopathological identification of at least two different morphologically distinctive vascular components in proper clinical settings. Exceedingly rare cases of this neoplasm can exhibit areas resembling high-grade angiosarcoma, which does not change the biological behaviour. Such lesions tend to occur in the setting of chronic lymphoedema and thus, can mimic Stewart-Treves syndrome, which has a much worse clinical outcome and prognosis. Case presentation We present a case of 49 years old male suffering from chronic lymphoedema of the left lower extremity who had developed a composite haemangioendothelioma with high grade angiosarcoma-like areas mimicking the Stewart-Treves syndrome. Given the multifocality of the disease, the only potentially curable surgical treatment would be hemipelvectomy, which was refused by the patient. The patient has been followed-up, with no signs of local progression of the remaining disease, nor a distant spread outside the involved extremity for two years. Conclusions Composite haemangioendothelioma represents a rare malignant vascular tumour, with significantly more favourable biological behaviour than angiosarcoma, even in cases where angiosarcoma-like areas are present. For that reason, composite haemangioendothelioma can be easily misdiagnosed as true angiosarcoma. The rarity of this disease unfortunately hampers the development of clinical practice guidelines and the implementation of treatment recommendations. Most of the patients with localized tumour are treated by wide surgical resection, without neo- or adjuvant radiotherapy or chemotherapy. However, in the case of this diagnosis, the watch-and-wait approach is better than mutilating procedure, highlighting the necessity of establishing of the correct diagnosis.

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Cutaneous Angiosarcoma Postmastectomy (Stewart-Treves Syndrome)

Cited by 3 publications

References 1 publication

Angiosarcoma secondary to postirradiation and chronic lymphedema

Angiosarcoma secondary to postirradiation and chronic lymphedema

Case for diagnosis. Stewart-Treves syndrome after mastectomy

Patient with composite haemangioendothelioma containing angiosarcoma-like areas in the setting of congenital lymphoedema mimicking Stewart-Treves syndrome: a case report

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