Role of surgery in the management of postmastectomy extremity angiosarcoma (Stewart-Treves syndrome)

Grobmyer, Stephen R.; Daly, J.M.; Glotzbach, Raymond E.; Grobmyer, Albert J.

doi:10.1002/(sici)1096-9098(200003)73:3<182::aid-jso14>3.0.co;2-n

Cited by 71 publications

(26 citation statements)

References 65 publications

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“…Both the conventional (sporadic) type as well as the lymphoedema‐associated variants are characterized by a high metastatic rate and poor 5‐year survival of only approximately 10% 1,3 , 6,29 , 47,63 . The reported clinical behaviour of postradiation angiosarcoma, however, has been controversial and definitive statements are difficult to make due to the limited number of cases and available follow‐up data.…”

Section: Cutaneous Angiosarcomamentioning

confidence: 99%

Postradiation vascular proliferations: an increasing problem

2005

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The occurrence of cutaneous vascular lesions is a rare but well-documented complication of radiation treatment and may be associated with significant morbidity as well as mortality. The overall incidence is low but appears to be rising due to a change in the prevailing treatment of breast carcinoma with increased use of radiation in the setting of breast-conserving therapy for stage 1 and 2 disease. The spectrum of postradiation vascular lesions is wide and ranges from atypical vascular lesions with reportedly benign clinical behaviour to frank cutaneous angiosarcoma. There is, however, significant clinical as well as histological overlap. It is frequently difficult to classify these postradiation vascular lesions accurately and they create an emerging diagnostic and therapeutic challenge to both pathologists and clinicians. Experience with these vascular lesions is very limited, and this article aims to provide an overview of our current understanding and concept of radiation-associated vascular lesions with focus on their clinical and histological presentation as well as behaviour and treatment.

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Section: Cutaneous Angiosarcomamentioning

confidence: 99%

Postradiation vascular proliferations: an increasing problem

2005

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“…Tanto la amputación como la escisión mejoraron la sobrevida en comparación a la radioterapia o quimioterapia 14 . La presencia de metástasis pulmonares en el caso relatado, alejaron la opción quirúrgica como tratamiento posible.…”

Section: Discussionunclassified

Síndrome de Stewart-Treves: Caso clínico

Silvariño¹,

Mérola²,

Figoli³

et al. 2010

Rev. méd. Chile

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Stewart-Treves syndrome. Report of one case Angiosarcomas are malignant tumors derived from the endothelium of blood vessels (hemangiosarcomas) or lymph vessels (lymphangiosarcomas). Lymphedema of the limbs is considered secondary when extrinsic injuries are observed and primary when these injuries are not present. Stewart-Treves syndrome or a Lymphangiosarcoma, developed over a chronic lymphedema, is a rare complication described in mastectomized patients but it can be observed in lymphedemas located elsewhere. It appears as nodular skin lesions that grow, multiply quickly and frequently metastasize. We report a 40-year-old male with an angiosarcoma associated with primary chronic lower limb lymphedema. The patient consulted for a history of weight loss and malaise and appearance of violaceous lesions over the zone of lymphedema and inguinal lymph node involvement. A CT scan showed bilateral lung lesions and enlargement of inguinal and iliac lymph nodes. A biopsy of one of the skin lesions disclosed an angiosarcoma, diagnosis that was confirmed with immunohistochemistry. Chemotherapy was started but the patient died five months after the diagnosis.

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“…Os autores relatam também a sua experiência com a utilização de quimioterapia (actinomicina D 2 mg intravenosa), associada à radioterapia, após tratamento cirúrgico, apresentando bons resultados, após dois anos de seguimento. Atualmente, o agente quimioterápico mais freqüentemente utilizado para tratamento de sarcomas vasculares, é a doxorrubicina isolada ou associada a outros agentes 13 . Grobmyer et al 13 , no seu trabalho de revisão da literatura, avaliando 92 casos dessa síndrome, concluíram que excisão local ampla é equivalente à amputação do membro e que a quimioterapia, com ou sem radioterapia, tem sido reservada para tratamento de pacientes com doença inoperável, que desenvolveram recorrência, ou que tenham recusado a amputação.…”

Section: Discussionunclassified

“…Os autores observaram sobrevida, após o diagnóstico dessa neoplasia vascular, variando de 8 a 15 meses. Grobmyer et al 13 encontraram sobrevida média, para pacientes com essa doença, de 20 meses. Por sua vez, Aygit et al 14 relatam um caso dessa síndrome, que veio a óbito seis meses após a amputação do membro superior, pondo em evidência que o tratamento dessa síndrome é tido como insatisfatório.…”

Section: Discussionunclassified