Angiosarcoma associated with chronic lymphedema (Stewart-Treves syndrome) of the leg: MR imaging

Nakazono, Takahiko; Kudo, Sho; Matsuo, Yoshitomo; Matsubayashi, Roka Namoto; Ehara, Shigeru; Narisawa, H; Yonemitsu, Nobuhisa

doi:10.1007/s002560000225

Cited by 36 publications

(19 citation statements)

References 5 publications

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“…A potential reason for this is that the tumors demonstrated a visually recognizable difference in signals in the two STS types. It is hypothesized that there are two reasons why there are SI alterations in MRIs: One is the proportion of tumor cells and blood vessels in the tumor (22,23), and the other is due to the abnormal amount of fat and fibrous tissues in LE (23). A similar difference occurred in the present study too.…”

Section: --------------------supporting

confidence: 76%

Stewart‑Treves syndrome: Magnetic resonance imaging data compared with pathological results from a single center

Wang

2017

Oncol Lett

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Abstract. The aim of the present study was to evaluate the magnetic resonance imaging (MRI) data of patients with Stewart-Treves Syndrome (STS), and to compare them with the corresponding pathological data. A total of 4,289 cases of secondary upper limb lymphedema (LE) from a single center, including 5 female cases of STS who underwent modified-radical post mastectomy, were included in the study. All cases were diagnosed pathologically, and by conventional and contrast-enhanced (ce)MRI scans. A total of 43 tumor nodules (Φ ≥4 mm) were examined. According to the immunohistochemical results, the 5 cases of STS were divided into 2 types; 4 patients exhibited STS type I [angiosarcoma (AS)] and 1 patient exhibited STS type 2 [mixed lymphangiosarcoma (mLAS)]. The MRI signal intensity (SI) of all the nodules was compared with the pathological results. In the T1WI sequences, all nodules showed isointensity compared with normal muscle tissues in the same image. However, in the T2WI sequences, there were the visually recognizable differences in the SI compared with the LE tissues in the two STS types. The SI of mLAS was more markedly decreased compared with that of AS. The SI of mLAS was closer to that of normal muscle tissues compared with the SI of AS. In the ceMRI, the SI of the tumor nodules was markedly increased in the two STS types, compared with non-enhancement imaging. Overall, MRI is a useful tool for the evaluation and diagnosis of STS. A chronic case of LE, in which MRI examination demonstrates nodules within the LE, may suggest a diagnosis of STS.

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Section: --------------------supporting

confidence: 76%

Stewart‑Treves syndrome: Magnetic resonance imaging data compared with pathological results from a single center

Wang

2017

Oncol Lett

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“…Unfamiliarity with this malignancy and the often innocuous appearance may lead to delayed diagnosis. We describe a case of upper-extremity angiosarcoma developing after mastectomy with emphasis on magnetic res-onance (MR) imaging, which has rarely been reported in the world radiology literature [3,4]. The unusual features of our case are the subcutaneous location and multiplicity of the tumorous lesions as well as the decreased signal intensity on T2-weighted images of a sarcoma that histologically turned out to be an angiosarcoma.…”

Section: Introductionmentioning

confidence: 92%

Stewart-Treves syndrome: MR imaging of a postmastectomy upper-limb chronic lymphedema with angiosarcoma

et al. 2004

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The rare occurrence of angiosarcoma in postmastectomy upper-limb lymphedema with magnetic resonance (MR) imaging is discussed. Unfamiliarity with this aggressive vascular tumor and its harmless appearance often leads to delayed diagnosis. Angiosarcoma complicating chronic lymphedema may be low in signal intensity on T2-weighting and short tau inversion recovery (STIR) imaging reflecting the densely cellular, fibrous stroma, and sparsely vascularized tumor histology. Additional administration of intravenous contrast medium revealed significant enhancement of the tumorous lesions. Awareness of angiosarcoma and its MR imaging appearance in patients with chronic lymphedema may be a key to early diagnosis or allow at least inclusion in the differential diagnosis.

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“…Angiosarcoma may develop in chronic lymphedematous limbs (Stewart-Treves syndrome), but is most commonly seen in the upper extremity following mastectomy with nodal dissection. 10,11 This is often referred to as lymphangiosarcoma, which is actually a misnomer, since the tumor is not derived from lymphatic vessels, but is rather derived from vascular endothelial cells within chronic lymphedema. Treatment is predominantly radiotherapy, and surgery is reserved for those with isolated disease.…”

Section: Clinical Presentationmentioning

confidence: 98%

Lower extremity lymphedema

Kerchner,

Fleischer,

Yosipovitch

2008

Journal of the American Academy of Dermatology

175

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Angiosarcoma associated with chronic lymphedema (Stewart-Treves syndrome) of the leg: MR imaging

Cited by 36 publications

References 5 publications

Stewart‑Treves syndrome: Magnetic resonance imaging data compared with pathological results from a single center

Stewart‑Treves syndrome: Magnetic resonance imaging data compared with pathological results from a single center

Stewart-Treves syndrome: MR imaging of a postmastectomy upper-limb chronic lymphedema with angiosarcoma

Lower extremity lymphedema

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