Stewart Treves Syndrome in a Woman with Mastectomy

Alan, Sevil; Aktaş, Habibullah; Ersoy, Ömer Faik; Aktümen, Alpay; Erol, Harun

doi:10.7860/jcdr/2016/17541.7288

Cited by 3 publications

(4 citation statements)

References 9 publications

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“…The presentation of papules is low (7.0%). Multiple colors were described: purplish to brownish, erythematous, erythematous‐blue, erythematous‐violet, blue‐red, blue‐black, purple‐red, purple, hemorragic or ecchymotic . There are few reports of the aspect of bluish hematoma surrounded by a halo of bruise, or the description of yellowish halo around the lesion, resembling hematoma in resorption .…”

Section: Discussionmentioning

confidence: 80%

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Unsuspected Stewart–Treves syndrome clinically mimicked by apparent bullous erysipelas and a systematic review of dermatological presentations of the classical Stewart–Treves syndrome

et al. 2018

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Background Stewart Treves–Syndrome (STS) was first characterized as angiosarcoma in the homolateral limb of a patient with breast cancer and lymphedema. Now, other conditions represent STS. It's a rare condition. The diagnosis is easier in the presence of single or multiple purple nodules. Even though other dermatological aspects have been reported, no study has grouped its characteristics. Aim Evaluate the dermatological characteristics of classical STS (c‐STS). Methods and Results We report a patient with chronic lymphedema with a history of recurrent erysipelas that rapidly developed multiple papules in the superior limb. It was initially diagnosed as bullous erysipelas, but unsatisfactory evolution led to biopsy, which demonstrated an unsuspected epithelioid angiosarcoma. We have also performed a review of dermatologic aspects of c‐STS using PubMed and Lilacs databases. PICTOS methodology and PRISMA flow chart were considered. The main dermatological aspects associated with c‐CTS were summarized. Using a systematic evaluation from 109 articles, 29 were selected and 44 patients were described to whom we added one case. The mean time with lymphedema was 10 years. Of the patients analyzed, 97.2% were female; 95.6% were submitted to radical mastectomy; 81.2% presented with multiple lesions, 67.4% of the lesions were reported as nodules or tumors, 53.4% were purple, 33.4% were associated with an ecchymotic halo, and 33.4% were ulcerated lesions. Conclusion When evaluating patients with chronic lymphedema with new dermatological abnormalities, clinical suspicion, or unfavorable evolution, the knowledge of clinical signs is important for diagnosis, and a biopsy must be considered. Papules associated with erythematous‐wine color and bluish hematoma aspect must raise clinical suspicion.

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Section: Discussionmentioning

confidence: 80%

“…For initial evaluation, 35 articles were selected. When patients were selected for analysis, 29 articles met the criteria of inclusion, within which 44 patients were identified. Three articles presented multiple cases, and their cases were assessed separately.…”

Section: Resultsmentioning

confidence: 99%

Unsuspected Stewart–Treves syndrome clinically mimicked by apparent bullous erysipelas and a systematic review of dermatological presentations of the classical Stewart–Treves syndrome

et al. 2018

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“…The overall prognosis of STS is poor; it is characterized by rapid progression, and is prone to distant metastasis. Its incidence is about 0.07-0.45% of patients who survive more than 5 years after breast cancer surgery (5)(6)(7). Therefore, the clinical understanding of STS in the lower limbs is generally insufficient, and it is easily misdiagnosed and missed.…”

Section: Discussionmentioning

confidence: 99%

A rare and highly malignant Stwart-Treves syndrome case after breast cancer surgery: a case report

Lu¹,

Yang²,

Zhu³

et al. 2022

Gland Surg

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Background: Stewart-Treves syndrome (STS) is a lymphatic sarcoma secondary to chronic lymphedema of the extremities. Most STS patients have a history of breast cancer and have undergone radical mastectomy and postoperative radiation and chemotherapy. It usually occurs 11 to 12 years after surgery, and about 0.45% of patients are estimated to have the disease. The characteristics of STS include that it is clinically relatively rare, has a high degree of malignancy, can spread easily in the absence of timely treatment, and has low survival rate. Herein, we report a case of STS which developed 13 years after breast cancer-related lymphoedema (BCRL). It allows doctors to recognize and detect the disease earlier.Case Description: A 74-year-old woman had undergone modified radical mastectomy 13 years ago for invasive ductal breast cancer in her left breast. After multiple rounds of postoperative chemoradiotherapy, multiple purple lesions were found in the left upper limb during physical examination in April 2021. The lesions spread rapidly and were varied in size. An immediate skin biopsy reported the lesions as STS. The patient was diagnosed with lymphangiosarcoma with metastasis (STS). The surgical method was shoulder joint amputation, chest wall resection, and local flap transfer. After surgery, the patient underwent 6 rounds of paclitaxel 300 mg + carboplatin 300 mg chemotherapy. After chemotherapy, the patient's wound healed and the suspected metastasis disappeared. At the time of writing, she has survived for more than 13 months, and her quality of life has improved significantly, to the satisfaction of the patient and her family. The patient is able to eat normally and lead a normal life with some assistance, without significant weight loss.Conclusions: Although rare, STS is a serious invasive complication of breast cancer surgery. To increase their relative survival time, patients with BCRL need to identify and thoroughly investigate rapidly progressing skin lesions, and undergo timely surgery.

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“…STS is a rare but deadly angiosarcoma that develops due to chronic lymphatic obstruction; STS may be either primary or secondary (1-10), and affects an estimated 0.07%-0.45% of patients who survive longer than five years after radical mastectomy (7,(10)(11)(12).…”

Section: Discussionmentioning

confidence: 99%

Stewart-Treves Syndrome: A Rare But Aggressive Complication of Breast Cancer-Related Lymphedema

Borman¹,

Yaman²,

Gököz³

2021

EJBH

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Stewart-Treves syndrome (STS) is an angiosarcoma that usually develop in an extremity with longstanding lymphedema. Most affected patients have a history of breast cancer treated with radical mastectomy. Here, we report a case of STS with breast cancer-related lymphedema (BCRL) for a period of seven years. A 56-year-old woman presented with chronic lymphedema of the left arm. Nine years previously she had modified radical mastectomy for grade 2, invasive, ductal breast cancer. Upon physical examination, a tender, purplish lesion on the medial half of the affected arm was observed. The lesion spread rapidly with different-sized, scattered, purple-colored lesions in the affected area. A prompt skin biopsy was reported as STS. An immediate arm amputation was performed. However, a few months later she presented with new lesions on the anterior thorax and subsequent local recurrence around the scar. She received radiation-therapy. However, six months later the angiosarcoma had spread to the pelvic and upper limb area with scattered skin lesions. She had several problems during the chemotherapy and radiation-therapy, although she survived beyond 20 months.In conclusion, STS is a rare but aggressive and important complication of BCRL. Awareness of rapidly progressing skin lesions and detailed investigation, as well as prompt surgery is necessary for patients with BCRL in order to relatively increase the survival time.

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Stewart Treves Syndrome in a Woman with Mastectomy

Cited by 3 publications

References 9 publications

Unsuspected Stewart–Treves syndrome clinically mimicked by apparent bullous erysipelas and a systematic review of dermatological presentations of the classical Stewart–Treves syndrome

Unsuspected Stewart–Treves syndrome clinically mimicked by apparent bullous erysipelas and a systematic review of dermatological presentations of the classical Stewart–Treves syndrome

A rare and highly malignant Stwart-Treves syndrome case after breast cancer surgery: a case report

Stewart-Treves Syndrome: A Rare But Aggressive Complication of Breast Cancer-Related Lymphedema

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