Cutaneous lymphangitis carcinomatosa made cervicofacial oedema intractable in a patient with superior vena cava syndrome

Abstract

Cutaneous lymphangitis carcinomatosa (CLC) is a rare form of cutaneous metastasis that causes lymphoedema and various eruptions. We report a case of lung cancer with CLC that caused both superior vena cava (SVC) stenosis and cervicofacial oedema, suggestive of SVC syndrome. A 64-year-old woman with lung adenocarcinoma presented with cervicofacial oedema and erythema, followed by severe dyspnoea 2 months after four cycles of carboplatin, pemetrexed and bevacizumab triplet therapy. Although chest CT indicated SVC stenosis, cervicofacial oedema remained despite treating the SVC stenosis via balloon dilation. A skin biopsy of the erythematic sample confirmed CLC as the cause of the patient’s symptoms. CLC should be considered as a differential diagnosis of cervicofacial oedema in addition to SVC syndrome, especially when it is observed in combination with skin erythema and induration. Moreover, a skin biopsy should be performed promptly for accurate diagnosis of CLC and to decide on appropriate treatment.

Cutaneous lymphangitis carcinomatosa: a unique presentation of a rare disease

“…Cutaneous lymphangitis carcinomatosa is defined as invasion of the dermis and subcutaneous lymphatic system by malignant cells [1][2][3][4][5]. It is a rare form of cutaneous metastasis with a variety of clinical presentations that can alert healthcare providers to cancer recurrence or even previously undiagnosed malignancy [2][3][4].…”

Lymphangitis Carcinomatosa in Neck Soft Tissue: Computed Tomography Findings With Emphasis on Differentiation From Cellulitis

“…The diagnosis of LC needs to be established in a timely fashion because early and appropriate treatment may improve outcome. Several previous case reports have described the clinical and pathological findings of LC involving skin or soft tissue 6,9–12 . However, to our knowledge, there has been no published work on the imaging findings of this rare entity.…”

“…clinical and pathological findings of LC involving skin or soft tissue. 6,[9][10][11][12] However, to our knowledge, there has been no published work on the imaging findings of this rare entity. Although LC may occur as a result of metastases from various histological types of malignant tumor, the most common type was adenocarcinoma in the lung.…”

“…The most common clinical manifestation of LC is soft tissue swelling, which may give a similar appearance to soft tissue infection. 6,[9][10][11][12] The purpose of our study was to evaluate the computed tomography (CT) findings of LC in the soft tissue of the neck, with emphasis on differentiation from cellulitis.…”

“…In the head and neck skin or soft tissue, LC has been rarely reported in the literature probably because head and neck cancer is most commonly squamous cell carcinoma. The most common clinical manifestation of LC is soft tissue swelling, which may give a similar appearance to soft tissue infection 6,9–12 …”