Lymphedema of the Arm after COVID-19 Vaccination in a Patient with Hidden Breast Cancer and Paraneoplastic Dermatomyositis

Abstract

The pandemic outbreak of Coronavirus Disease 2019 (COVID-19) led to the development of mRNA vaccines. With the extensive vaccination campaign performed worldwide, many adverse reactions to these drugs have been reported in the literature. Although most of them are mild and self-limiting, they may sometimes cause psychological stress and require efforts to make a differential diagnosis with other conditions. This is the case of lymphadenopathies and lymphedema in patients with a history of cancer. Herein we present a case of lymphedema of the arm developed ten days after a VAXZEVRIA COVID-19 vaccine shot in a patient who had concomitant signs and symptoms compatible with a diagnosis of dermatomyositis. It was later classified as paraneoplastic as instrumental investigation revealed a breast carcinoma contralateral to the site of vaccine injection. With this report we ponder an adverse reaction to COVID-19 vaccination with the aim of bringing new data for clinicians who face similar clinical presentations, particularly controversial for radiologists and oncologists.

Ipsilateral Upper-Limb Lymphedema After COVID-19 Vaccine Booster

“…An 84-year-old woman presents with a 6-month history of left upper-limb swelling; the only history of note was an intramuscular Pfizer-BioNTech mRNA vaccine booster 1 in the ipsilateral deltoid just 1 week before the onset of the swelling. A CT thorax, abdomen, and pelvis done as part of surveillance for her resected gastric cancer were unremarkable 2 . An ultrasound deep venous thrombosis of the left upper limb shows thickening of the subcutaneous tissue layer but was otherwise unremarkable.…”

“…A CT thorax, abdomen, and pelvis done as part of surveillance for her resected gastric cancer were unremarkable. 2 An ultrasound deep venous thrombosis of the left upper limb shows thickening of the subcutaneous tissue layer but was otherwise unremarkable.…”