ABSTRACT
Stewart-Treves Syndrome is characterized by the presence of lymphangiosarcoma on limb extremities. Rare, it occurs in 0.5% of patients who have undergone radical mastectomy with axillary node dissection. The main cause is chronic lymphedema with endothelial and lymphatic differentiation, with no direct relationship to breast cancer. Seven years after a radical right-side mastectomy with lymph node dissection and adjuvant therapy, the patient developed a lesion on her right arm. The dermatological examination revealed an erythematous nodule with bleeding surface on chronic right forearm lymphedema. After the biopsy, a lymphangiosarcoma on chronic lymphedema was diagnosed. Infrequent, this syndrome is relevant because of its associated mortality. Early diagnosis is important to improve survival and reduce complications.
.Subject(s)
Humans , Female , Aged , Skin Neoplasms/pathology , Hemangiosarcoma/pathology , Lymphangiosarcoma/pathology , Lymphedema/pathology , Arm , Skin Neoplasms/surgery , Skin Neoplasms/etiology , Biopsy , Amputation, Surgical , Hemangiosarcoma/surgery , Hemangiosarcoma/etiology , Lymphangiosarcoma/surgery , Lymphangiosarcoma/etiology , Lymphedema/surgery , Lymphedema/etiology , Mastectomy , Neoplasm Recurrence, LocalABSTRACT
Os autores relatam um caso de linfangiossarcoma pós-mastectomia (síndrome de Stewart-Treves). Trata-se de complicaçäo rara e extremamente grave do linfedema crônico. Após revisäo da literatura, concluem que todas as formas terapêuticas, incluindo cirurgia, radioterapia e quimioterapia, säo insatisfatórias. Para melhorar a sobrevida, é fundamental o diagnóstico precoce através de biópsia em todos os casos de lesäo suspeita. A prevençäo é também muito importante, através da profilaxia do linfedema pós-operatório e do tratamento adequado quando este ocorre