Unexpected Lymphatic Drainage of the Treated Breast

Purpose Klippel-Trenaunay syndrome (KTS) is a rare disease that was characterized by vascular malformation. Lymphatic malformation was also commonly associated with KTS. However, the application of lymphoscintigraphy in the management of patients with KTS was rarely described. The purpose of this study is to assess whether the findings of lymphoscintigraphy can aid the management of the patients with KTS. Methods A total of 28 patients with known KTS who underwent 99mTc-dextran lymphoscintigraphy with lower extremity tracer injection were included in this retrospective analysis. The images from lymphoscintigraphy were reviewed for any abnormalities in the body with the attention on the region of left subclavian-jugular venous angle. Results In addition to abnormal activity in the other regions, abnormal activity in the left subclavian-jugular venous angle was visualized in over half of the patients (53.6%, 15/28). Based on the findings of the lymphoscintigraphy, 7 patients with left subclavian-jugular venous angle activity underwent thoracic duct decompression. In 4 patients with postsurgery follow-up, 3 achieved significant, measurable symptomatic relief. Conclusions Lymphoscintigraphy can be used to assess potential candidates for thoracic duct decompression to alleviate the symptoms in patients with KTS.

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A case of contralateral inguinal lymph node metastases from breast cancer

Kimoto

Kohno

Okamoto

et al. 2021

surg case rep

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Background Breast cancer is well known to tends to invade through the lymphatic chains mainly to the axillary and subclavian nodes or occasionally to the internal mammary nodes. However, inguinal lymph node metastasis from breast cancer is extremely rare. Case presentation We have experienced a case of an 82-year-old woman showing left inguinal lymph node metastases from right breast cancer. Previously, she had received five times abdominal operations and left artificial bone head replacement for metamorphous hip-joint disease. Although the metastases were firstly detected 46 months after the breast surgery, they had already existed at the time of the breast operation, which was retrospectively re-evaluated by CT examination. The progression pattern of inguinal lymph node metastases had much correlated with that of the breast cancer. She underwent inguinal lymph node dissections. Pathological findings revealed them being compatible with breast cancer origin. Conclusions This is the sixth case having been reported in English literature. Besides, this is the first case showing the contralateral spread to the primary breast cancer. One of the causes of this complex metastatic pattern is thought be ascribed to the previously performed prolific abdominal operations.

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Unexpected Lymphatic Drainage of the Treated Breast

Cited by 4 publications

References 9 publications

Options of locoregional therapy for primary foci of breast cancer influence the rate of nonregional lymph node metastasis in N2–N3 status patients: a SEER database analysis

Options of locoregional therapy for primary foci of breast cancer influence the rate of nonregional lymph node metastasis in N2–N3 status patients: a SEER database analysis

Potential Utilization of Lymphoscintigraphy in Patients With Klippel-Trenaunay Syndrome

A case of contralateral inguinal lymph node metastases from breast cancer

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