Proteus syndrome is a very rare congenital condition comprising malformations and overgrowth of multiple sorts of tissue. It was described for the first time in 1979 and was termed Proteus syndrome in 1983. The authors describe a 37-year-old patient who was diagnosed initially as having Klippel-Trenaunay-Weber syndrome at the age of 10 years. The patient was operated for a major thoracic lymphatic malformation, which caused functional problems. The operation at older age for this large lymphatic malformation proved to be complex. In addition, the authors address the difficulties in diagnosing Proteus syndrome. Vascular malformations causing functional problems in adulthood require major surgical procedures with a high risk of postoperative complications.
In 110 patients 127 radiocephalic arteriovenous fistulas were performed as vascular access for chemotherapy. If patients did not receive cytostatic agents prior to the operation or were treated for less than 4 weeks, the success rate of the operation was 75%. If chemotherapy was administered for longer than 4 weeks, it was possible to construct a functioning fistula in only 28 % of patients. The radiocephalic arteriovenous fistula is considered to be a convenient access for chemotherapy provided the operation is performed before the start of the treatment.
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